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首页> 外文期刊>Osteoarthritis and cartilage >Predictors of moderate-severe functional limitation after primary Total Knee Arthroplasty (TKA): 4701 TKAs at 2-years and 2935 TKAs at 5-years.
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Predictors of moderate-severe functional limitation after primary Total Knee Arthroplasty (TKA): 4701 TKAs at 2-years and 2935 TKAs at 5-years.

机译：初次全膝关节置换术（TKA）后中度至重度功能受限的预测指标：第2年为4701 TKA，第5年为2935 TKA。

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OBJECTIVE: Investigate whether body mass index (BMI), comorbidity, gender and age predict patient-reported functional limitation 2- and 5-years after primary Total Knee Arthroplasty (TKA). METHODS: Overall moderate-severe activity limitation was defined as > or = 2 activities (walking, stairs, rising from chair) with moderate-severe limitation. Complete dependence on walking aids or inability to walk was assessed (reference, no dependence). Multivariable logistic regression models were adjusted additionally for income, diagnosis, distance from medical center, American Society of Anesthesiologists (ASA) score and implant type. RESULTS: Overall moderate-severe activity limitation was reported by 20.7% at 2-years and 27.1% at 5-years. Significantly predictors of overall moderate-severe activity limitation 2-years post-TKA (odds (95% confidence interval)) were: BMI 30-34.9, 1.5 (1.0, 2.0), 35-39.9, 1.8 (1.3, 2.7) and > or = 40, 3.0 (2.0, 4.5) vs BMI < or = 25; higher Deyo-Charlson index, 1.7 (1.4, 2.2) per 5-point increase; female gender, 2.0 (1.7, 2.5); age 71-80, 2.1 (1.5, 2.8) and age > 80, 4.1 (2.7, 6.1) vs age < or = 60. At 5-years post-TKA, significant predictors of overall moderate-severe activity limitation were: BMI 35-39.9, 2.1 (1.4, 3.3) and > or = 40, 3.9 (2.3, 6.5); higher Deyo-Charlson index, 1.4 (1.0, 1.8); female gender, 2.2 (1.7, 2.7); age 71-80, 2.4 (1.7, 3.5) and age > 80, 4.7 (2.8, 7.9). Complete dependence on walking aids was significantly higher at 2- and 5-years, respectively, in patients with: higher comorbidity, 2.3 (1.5, 3.3) and 2.1 (1.4, 3.2); female gender 2.4 (1.5, 3.9) and 1.7 (1.1, 2.6); age 71-80, 1.4 (0.8, 2.6) and 1.5 (0.8, 2.8); and age > 80, 3.2 (1.6, 6.7) and 5.1 (2.3, 11.0). CONCLUSIONS: Modifiable (BMI, comorbidity) and non-modifiable predictors (age, gender) increased the risk of functional limitation and walking-aid dependence after primary TKA. Interventions targeting comorbidity and BMI pre-operatively may positively impact function post-TKA.
机译：目的：调查体重指数（BMI），合并症，性别和年龄是否可以预测患者在初次全膝关节置换术（TKA）后2和5年报告的功能受限。方法：将总体中度-重度活动限制定义为≥2个活动（步行，楼梯，从椅子上抬起）且具有中度-重度活动限制。评估完全依赖助行器或不能行走的情况（参考，无依赖）。还针对收入，诊断，距医疗中心的距离，美国麻醉医师学会（ASA）得分和植入物类型对多变量logistic回归模型进行了调整。结果：总体中度-重度活动受限报告为2年为20.7％，5年为27.1％。 TKA发生2年后总体中度至重度活动受限的显着预测指标（几率（95％置信区间））为：BMI 30-34.9、1.5（1.0、2.0），35-39.9、1.8（1.3、2.7）和>或= 40，3.0（2.0，4.5）vs BMI <或= 25; Deyo-Charlson指数更高，每增加5点增加1.7（1.4，2.2）;女性，2.0（1.7，2.5）; 71-80岁，2.1（1.5、2.8）和80岁以上，4.1（2.7、6.1）岁与60岁以下或60岁之间。在TKA后5年，总体中度-重度活动受限的重要预测指标为：BMI 35 -39.9、2.1（1.4、3.3）和>或= 40、3.9（2.3、6.5）; Deyo-Charlson指数更高，为1.4（1.0，1.8）;女性，2.2（1.7，2.7）; 71-80岁，2.4（1.7、3.5）和80岁以上> 4.7（2.8、7.9）。在合并症，2.3（1.5、3.3）和2.1（1.4、3.2）较高的患者中，对助行器的完全依赖性分别在2岁和5岁时明显更高。女性2.4（1.5，3.9）和1.7（1.1，2.6）; 71-80岁，1.4（0.8、2.6）和1.5（0.8、2.8）;和年龄> 80、3.2（1.6、6.7）和5.1（2.3、11.0）。结论：可修改的（BMI，合并症）和不可修改的预测因子（年龄，性别）增加了原发性TKA后功能受限和助走依赖的风险。术前针对合并症和BMI的干预可能对TKA后的功能产生积极影响。

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