因膝关节假体周围感染接受膝上截肢术患者术后主客观满意度分析

杨晨辰; 纪保超; 李国庆; 张晓岗; 胥伯勇; 阿斯哈尔江 ·买买提依明; 曹力

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0203

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因膝关节假体周围感染接受膝上截肢术患者术后主客观满意度分析

假体周围感染专题 | 更新时间：2024-02-19

- 因膝关节假体周围感染接受膝上截肢术患者术后主客观满意度分析
- Satisfaction of Patients with Above-the-knee Amputation following Periprosthetic Joint Infection
- 中山大学学报（医学科学版） 2023年44卷第2期页码：198-208
- 作者机构：
  
  新疆医科大学第一附属医院骨科中心关节外科，乌鲁木齐，830054
- 作者简介：
  
  杨晨辰，硕士生，骨与关节疾病，E-mail：2596243576@qq.com
- 基金信息：
  
  新疆维吾尔自治区自然科学基金资助项目(2021D01C330)
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0203
  中图分类号： R687.4
- 纸质出版日期：2023-03-20，
  
  收稿日期：2022-09-12，
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杨晨辰,纪保超,李国庆等.因膝关节假体周围感染接受膝上截肢术患者术后主客观满意度分析[J].中山大学学报（医学科学版）,2023,44(02):198-208.

YANG Chen-chen,JI Bao-chao,LI Guo-qing,et al.Satisfaction of Patients with Above-the-knee Amputation following Periprosthetic Joint Infection[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(02):198-208.
杨晨辰,纪保超,李国庆等.因膝关节假体周围感染接受膝上截肢术患者术后主客观满意度分析[J].中山大学学报（医学科学版）,2023,44(02):198-208. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0203.

YANG Chen-chen,JI Bao-chao,LI Guo-qing,et al.Satisfaction of Patients with Above-the-knee Amputation following Periprosthetic Joint Infection[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(02):198-208. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0203.

摘要

目的

评估因膝关节假体周围感染行膝上截肢术患者术后主观满意度与客观功能的关系。

方法

回顾性分析13例因膝关节假体周围感染行膝上截肢术患者，女性7例，男性6例，中位数为69 （45~ 73）岁。所有患者自初次膝关节置换术至截肢手术前因假体周围感染接受手术次数平均为2.9次（范围1～6）。13例患者按接受截肢手术时年龄被分为非老年组（<65岁）和老年组（≥65岁）。采用SF-12评分和Barthel指数评定量表评价患者术后功能及日常生活能力。通过调查问卷评价患者术后满意度。

结果

4例患者于截肢术后6个月内死亡，9名存活患者平均随访时间中位数为4.2 （1.9~8.2）年，其中3例患者术后因残肢感染再次入院接受手术治疗。非老年组患者术后均可佩戴假肢步行，老年组患者中仅1例患者术后可佩戴假肢行走。非老年组患者截肢术后功能评分明显优于老年组病例（

0.05），而老年组病例较年轻患者显示了更高的术后满意度。

结论

年轻的膝关节假体周围感染患者在接受膝上截肢术后功能水平及日常生活能力较高，然而由于对术后功能的较高期望和需求，使年轻患者对截肢手术的满意度低于老年患者；同时，尽管由于欠佳的全身状况导致老年患者截肢手术后功能水平较差，但因截肢手术减轻患者沉重的经济、心理负担以及老年人群对于功能相对偏低的期望值和需求，使老年患者对截肢手术后的生活状态感到相对满意。

Abstract

Objective

The purpose of this study was to evaluate the functional outcomes and satisfaction in periprosthetic knee infection patients after above-the-knee amputation （AKA）.

Methods

A review was performed in 13 patients who underwent AKA due to periprosthetic knee infection from October 2010 to August 2022， there were 7 females and 6 males with the median age of 69 （45~ 73） years. The mean number of surgical procedures between primary total knee arthroplasty and AKA was 2.9 times （range： 1 ~ 6）. Patients were segregated into non-elderly group （including patients <65 years old） and elderly group （involving patients ≥65 years old）. Functional outcomes were evaluated by SF-12 and Barthel activities daily living index （Barthel ADL index）. Patient satisfaction was accomplished through a questionnaire.

Results

Four patients died within 6 months after the amputation. Three patients received surgical procedures for recurrent infections after AKA. In the remaining 9 patients，the median time from AKA to the final follow-up was 4.2 （1.9~8.2） years， three patients received surgical procedures for recurrent infections after AKA. Patients in non-elderly group showed better functional outcomes than elderly patients after AKA （both

0.05）. All patients in non-elderly group were fitted with a prosthesis. Whereas， elderly patients reported a better satisfaction after AKA than young patients.

Conclusion

Young PJI patients seemed to have better function and ambulatory ability with high expectation and demand， which made them feel less satisfied about AKA. Meanwhile，despite poor function outcomes due to the less healthy physical condition， the alleviation of financial and psychological burdens resulting from reinfections and multiple surgeries and the less demand in function and daily activities made elderly patients have a good satisfaction after AKA.

关键词

假体周围感染满意度功能膝上截肢术

Keywords

PJIsatisfactionfunctionabove-the-knee amputation

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