肥胖对全膝关节置换术后患者疼痛和功能的影响

The Influence of Obesity on Pain and Function Following Primary Total Knee Arthroplasty:a Retrospective Study

目的评价和比较三组(正常组、超重组、肥胖组)患者全膝关节置换术(total knee arthroplasty,TKA)术后的视觉模拟评分(visual analogue scale,VAS)、膝关节活动度和并发症发生率,探讨肥胖对TKA术后患者早期疼痛和功能康复的影响。方法回顾性纳入2017年1月至2018年7月于我中心行初次单侧TKA的患者156例,按照身体质量指数(body mass index,BMI)分为正常组(18.0～23.9kg/m2)、超重组(24.0～27.9kg/m2)和肥胖组(BMI≥28.0kg/m2),正常组51例,超重组55例,肥胖组50例,比较患者的基线指标、术后第1、3、5、15天静息和活动状态的VAS评分,术后第5天和第15天的膝关节活动度及围术期并发症。结果三组患者术后第1、3、5、15天静息和活动状态下的VAS评分差异无统计学意义,术后第5天和第15天膝关节活动度的差异无统计学意义(P>0.05)。三组患者并发症的发生率无统计学差异,但肥胖组患者的术后住院时间更长(P=0.031)。结论肥胖不影响TKA患者术后的早期疼痛和功能康复,并不会增加并发症发生率,肥胖患者可以获得良好的功能康复效果,但需要更长的康复时间。

Objective To evaluate the influence of obesity on early pain and function following primary total knee arthroplasty(TKA)through comparing VAS score,the range of motion and complications among normal weight patients,overweight patients and obese patients.Methods A total of 156 patients who underwent primary TKA were divided into normal group(18.0~23.9 kg/m^2,overweight group(24.0~27.9 kg/m^2)and obese group(BMI≥28.0 kg/m^2)according to body mass index(BMI)from January 2017 to July 2018.We evaluated the baseline indicators,VAS score on the first,third,fifth and fifteenth days after operation.The range of motion and complications were evaluated on fifth and fifteenth days after operation.Results There was no difference in the VAS score of the resting and active state on the first,third,fifth and fifteenth postoperative days.In addition,range of motion and complications on fifth and fifteenth postoperative days were not significantly among the three groups(P>0.05).The length of stay in obese group was the longest(P=0.031).Conclusion Obesity does not affect patient's early pain and functional rehabilitation,does not increase complications following primary TKA.Obese patients can gain satisfactory functional rehabilitation outcomes while the rehabilitation duration is longer.