A Longitudinal Long-Term Study of Revision Total Hip Replacement or Revision Total Knee Replacement
| Autor: | Hung-Yi Chang, 張弘宜 |
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| Rok vydání: | 2011 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 99 Background: There are few longitudinal studies discussing health-related quality of life (QOL) of patients who have accepted revision total hip or knee replacement surgery (Revision THR / TKR). Therefore, the purposes of study are to evaluate QOL of patients at different time points, to compare responsiveness of different measures, to compare different viewpoints between surgeons and patients, and to explore the important factors with QOL. Finally, the study compares data from different countries and then provides a reference to patients. Methods: In Taiwan, 146 Revision THRs and 66 Revision TKRs patients from September 2007 to August 2009 were collected from three hospitals and included the study. All patients completed SF-36, Harris Hip Score and Lysholm Knee Scoring Scale at preoperative, 3, 6, 12, 24 months postoperatively. Descriptive statistics, responsiveness (such as: effect size, standardized response mean, minimal detectable change, and minimal clinically important difference), bootstrapping and the generalized estimating equations (GEE) were employed in this study. Results: 1. There are significant improvements in the SF-36 between preoperative and postoperative in Revision THRs and TKRs. However, there are no significant improvements on Physical Function, Social Function and General Health scores in Revision TKRs. In addition, there are significant improvements between preoperative and 3 months postoperatively on disease-specific measures in Revision THRs and TKRs. 2. Responsiveness of disease-specific measures is better than SF-36. 3. The disease-specific measure is better than SF-36, meaning that the surgeon’s perception of quality of life is better than patient’s. 4. Female, older, readmission, marriage, length of stay, length of surgery time, complications, Mechanical Loosening, Dislocation, Infection, AVN, AS and RA are negative impactors correlated with QOL. However, “satisfaction with the explanation/education after surgery”, “overall satisfaction after surgery” and “preoperative status” are positive impactors correlated with QOL. Conclusions: The study demonstrated that it improved QOL after Revision THR/TKR, the responsiveness of disease-specific measures is better than generic one, and the surgeons have better perception of quality of life than the patients. In addition, demographic characteristics, clinical factors, patient perception and satisfaction, preoperative function status are the important factors with health-related quality of life. In sum, health care providers could provide better medical education to patients by the study. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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