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首页> 外文期刊>Journal of Hand Surgery. American Volume >Hand appearance as a patient motivation for surgery and a determinant of satisfaction with metacarpophalangeal joint arthroplasty for rheumatoid arthritis.
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Hand appearance as a patient motivation for surgery and a determinant of satisfaction with metacarpophalangeal joint arthroplasty for rheumatoid arthritis.

机译：手的出现是患者手术的动机，也是对类风湿关节炎的掌指关节置换术满意程度的决定因素。

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PURPOSE: To determine patient motivations for surgery and satisfaction with outcomes for metacarpophalangeal (MCP) joint arthroplasty in 3 domains (appearance, function, and pain) and whether patient-reported satisfaction correlates with standard outcome measures. METHODS: In a randomized controlled trial of MCP joint implants, 33 patients with rheumatoid arthritis had primary MCP joint arthroplasty: 15 hands received Swanson implants, and 18 received NeuFlex implants. Range of motion, ulnar drift, grip strength, Sollerman hand function test, and the Michigan Hand Questionnaire were collected before surgery and 1 year after surgery. Preoperative patient motivations for and expectations of MCP joint arthroplasty were assessed for function, pain, and appearance. Patient-perceived improvement and satisfaction within the 3 domains and global satisfaction were assessed after surgery. RESULTS: Function was rated the most important motivator for surgery by 31 patients, pain by 22, and appearance by 15. Twenty-six patients rated 2 or more motivators equally high. Michigan Hand Questionnaire subscores were moderately correlated or weakly correlated with patient-reported satisfaction. The Sollerman score was weakly correlated with patient-reported satisfaction. Range of motion, ulnar drift, and grip strength were not correlated with patient-reported satisfaction. More patients stated that a much better improvement was obtained for appearance than for function or pain relief. CONCLUSIONS: Patient expectations of MCP joint arthroplasty were uniformly high. The greatest motivation for surgery was functional improvement. Pain was highly ranked, and 25 patients rated hand appearance as the first or second motivator. Patient satisfaction correlated poorly with traditional outcome measures and moderately with patient-reported outcomes. We conclude that appearance should be considered an important motivator for surgery and determinant of satisfaction. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.
机译：目的：确定患者的手术动机和对掌指关节成形术在三个方面（外观，功能和疼痛）的满意度，以及患者报告的满意度是否与标准结果相关。方法：在MCP关节植入物的随机对照试验中，有33名类风湿性关节炎患者进行了原发性MCP关节置换术：15例接受了Swanson植入物，而18例接受了NeuFlex植入物。在手术前和手术后1年收集运动范围，尺骨漂移，握力，索勒曼手功能测试和密歇根手问卷。评估术前患者对MCP关节置换术的动机和期望，以评估其功能，疼痛和外观。手术后评估患者在这三个方面的改善和满意度以及整体满意度。结果：31位患者被认为是手术的最重要动机，22位患者被认为疼痛，15位患者被认为是外科手术的最重要动机。26位患者对2项或以上动机的评价同样高。密歇根州手问卷调查分数与患者报告的满意度呈中度相关或弱相关。 Sollerman评分与患者报告的满意度呈弱相关。运动范围，尺骨漂移和握力与患者报告的满意度无关。更多的患者指出，与功能或缓解疼痛相比，外观获得了更好的改善。结论：患者对MCP关节置换术的期望一直很高。手术的最大动机是功能改善。疼痛排名最高，有25位患者将手的外观评为第一或第二动机。患者满意度与传统结局指标之间的相关性较差，与患者报告的结局之间的相关性中等。我们得出结论，外貌应被视为手术的重要动机和满意度的决定因素。研究类型/证据级别：治疗方法I.

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