体重指数对骨关节炎患者术后疗效的影响  

Effects of body mass index on postoperative outcome in patients with osteoarthritis after total knee arthroplasty

作　　者：杜晋强[1] 高耀祖[1] 张志强[1] 卫小春[1] 

机构地区：[1]山西医科大学第二医院骨科,山西太原030001

出　　处：《中国骨伤》2014年第11期916-919,共4页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金(编号:31271033)~~

摘　　要：目的 ：探讨不同体重指数（body mass index,BMI）对接受全膝关节置换术（total knee arthroplasty,TKA）的骨关节炎患者膝关节疗效的影响。方法：对2006年6月至2009年5月施行TKA并且有完整随访资料的148例骨关节炎患者进行回顾性分析,男29例,女119例;年龄39~89岁,平均71.2岁。按体重指数分类标准分为4组：非肥胖组（BMI≤25.0 kg/m2）38例45膝,男9例,女29例,平均年龄（70.0±8.2）岁;超重组（BMI 25.1~27.0 kg/m2）40例48膝,男10例,女30例,平均年龄（72.6±7.4）岁;肥胖组（BMI 27.1~30.0 kg/m2）37例43膝,男7例,女30例,平均年龄（70.4±6.0）岁;病理性肥胖组（BMI〉30.0 kg/m2）33例39膝,男3例,女30例,平均年龄（71.7±6.4）岁。分别记录各组术前和随访时KSS评分,膝前痛及手术时髌骨软骨损坏情况。结果：各组患者术后KSS评分与术前相比均有大幅提高,优良率97.1%。在膝评分方面,术前及术后各组之间差异均无统计学意义（术前P=0.789,术后P=0.133）;在膝功能评分中,肥胖组的术前功能评分最低,与其他组相比差异有统计学意义（术前P=0.036,术后P=0.225）。术后膝前痛发生率为9.7%（17/175）,其中14膝为Ⅰ级,3膝为Ⅱ级。各组术后膝前痛发生率差异无统计学意义（χ2=0.764,P=0.862）。发生膝前痛的患者平均体重指数（27.4±3.6）kg/m2,无膝前痛的患者平均体重指数（27.5±4.4）kg/m2,差异无统计学意义（t=-0.061,P=0.951）。各组髌骨软骨损坏程度差异无统计学意义（χ2=7.070,P=0.314）。结论 ：不同BMI患者膝关节评分和功能评分都有大幅提高,都能从TKA手术中获益,并且肥胖患者术后疗效可以与非肥胖患者一样好。Objective：To study effects of body mass index（BMI） on postoperative outcome in patients with osteoarthritis after total knee arthroplasty（TKA）. Methods：The data of 148 patients with osteoarthritis who underwent TKA from June 2006 to May 2009 in our hospital and had complete follow up data were analyzed restrospectively,including 29 males and 119 females,ranging in age from 39 to 89 years old,with an average age of 71.2 years old. According to BMI classification standard,all the patients were divided into 4 groups ：non obese group（BMI ≤25.0 kg / m2）,had 38 patients（45 knees）,including 9males and 29 females,with a mean age of（70.0±8.2） years old;overweight group（BMI 25.1 to 27.0 kg / m2）,had 40 patients（48 knees）,including 10 males and 30 females,with a mean age of（72.6±7.4） years old; obesity group（BMI 27.1 to 30.0 kg /m2）,had 30 patients（43 knees）,including 7 males and 30 females,with a mean age of（70.4±6.0） years old;morbidly obesity group（BMI 〉30.0 kg / m2）,33 patients（39 knees）,including 3 males and 30 females,with a mean age of（71.7±6.4） years old.The index such as Knee Society Score（KSS）,anterior knee pain and patella cartilage damage during surgery were recorded before surgery and at the time of follow up. Results：Postoperative KSS increased significantly compared to preoperative KSS,and the good rate reached to 97.1%. In the knee score,preoperative KSS and postoperative KSS had no significant differences among the four groups（preoperative P=0.789;postoperative P=0.133）. However,compared with other groups,obesity group got the lowest preoperative function score（preoperative P =0.036;postoperative P =0.225）. While the incidence of anterior knee pain was 9.7%（17 / 175）,including 14 grade Ⅰand 3 grade Ⅱ. There were no significant differences in incidence of anterior knee pain among four groups（χ2=0.764,P=0.862）. The average BMI of the patients with anterior knee pain was（27.4±3.6）kg / m2,while the others’ BM

关 键 词：骨关节炎 体重指数 关节成形术 置换 膝 疼痛 

分 类 号：R151[医药卫生—营养与食品卫生学]