TOTAL DİZ ARTROPLASTİSİ SONRASI AKUT POSTOPERATİF AĞRI VE FİZİKSEL FONKSİYON ÜZERİNDE PREOPERATİF FAKTÖRLERİN ROLÜ

Öz

Amaç: Total Diz Artroplastisi (TDA) sonrası akut dönemde bildirilen ağrı yakınmalarını ve fiziksel fonksiyonu etkileyebilecek preoperatif faktörler mevcuttur. Bu çalışma, TDA sonrası hastaların akut dönemde ağrı ve fiziksel fonksiyonuna etki edebilecek preoperatif faktörleri ortaya çıkarmak amacıyla planlandı. Yöntem: Çalışmaya yaş ortalamaları 66,5 ± 7,53 olan 70 hasta (53 kadın, 17 erkek) dahil edildi. Ameliyat öncesi hastaları değerlendirmek için Hospital for Special Surgery Diz Skorlaması, Vizüel Analog Skalası, Tampa Kinezyofobi Ölçeği, Hastane Anksiyete ve Depresyon Ölçeği, Uluslararası Fiziksel Aktivite Anketi Kısa Formu ve Vücut Farkındalığı Anketi kullanıldı. Ameliyat sonrası değerlendirmeler için Kısa Ağrı Anketi ve Süreli Kalk ve Yürü Testi kullanıldı. Sonuçlar: Postoperatif akut ağrı (PAA), preoperatif kinezyofobi, anksiyete, depresyon ve ağrı şiddeti ile ilişkili bulunurken (r=0,684, p=0,000; r=0,424, p=0,000; r=0,329, p=0,005; r=0,259, p=0,030, sırasıyla) postoperatif akut fiziksel performans (PAFP) preoperatif kinezyofobi ile ilişkili bulunmuştur (r=0,280, p=0,019). Preoperatif vücut farkındalığı ile PAA ve PAFP ile ilişkili olmadığı bulunmuştur (p>0,05). Preoperatif fiziksel aktivite düzeyi inaktif olanlar ile inaktif olmayanlar arasında PAFP açısından anlamlı fark bulunmuştur (p=0,000). Ameliyat öncesi diz ağrısı süresi 5 yıl ve altında olan hastalar ile 6 yıl ve üzerinde olan hastalar arasında PAA ve PAFP arasında istatistiksel olarak anlamlı bir fark bulunmuştur (p=0,025). Tartışma: Bu çalışmada tanımlanan preoperatif risk faktörlerinin değerlendirilmesi yoluyla akut postoperatif ağrı ve kötü fiziksel performans riski daha yüksek olan hastalar belirlenebilir.

Anahtar Kelimeler

• Akut Ağrı
• Diz Artroplastisi
• Fiziksel Fonksiyon
• Preoperatif Tahmin Edici
• İyileşme

THE ROLE OF PREOPERATIVE FACTORS ON ACUTE POSTOPERATIVE PAIN AND PHYSICAL FUNCTION AFTER TOTAL KNEE ARTHROPLASTY

Abstract

Purpose: Many preoperative factors can affect the pain and physical function complaints reported in the acute period after total knee arthroplasty (TKA). This study was planned to reveal the preoperative factors that may affect pain and physical function in the acute period of patients post-TKA. Methods: Seventy patients (53 women, 17 men) with a mean age of 66.5±7.53 years were enrolled in this study. Before the surgery, the Hospital for Special Surgery Knee Scoring, a Visual Analog Scale, the Tampa Kinesiophobia Scale, the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire Short Form and the Body Awareness Questionnaire were used to evaluate the patients. The Brief Pain Inventory and the Timed Up and Go Test were used for post-surgery assessments. Results: Postoperative acute pain (PAP) was associated with preoperative kinesiophobia, anxiety, depression, and pain severity (r=0.684, p=0.000; r=0.424, p=0.000; r=0.329, p=0.005; r=0.259, p=0.030, respectively). Postoperative acute physical performance (PAPP) was associated with preoperative kinesiophobia (r=0.280 ; p=0.019). It was found that there was no relationship between preoperative body awareness and acute postoperative pain and physical performance (p>0.05). There was a significant difference in PAPP between inactive and inactive preoperative physical activity levels (p=0.000). There was a statistically significant difference between the PAP and PAPP between patients with preoperative knee pain duration of 5 years and under and patients with 6 years or more (p=0.025). Conclusion: Through the assessment of the preoperative risk factors identified in this study, patients at higher risk of acute postoperative pain and poor physical performance can be identified.

Keywords

• Acute Pain
• Knee Arthroplasty
• Physical Function
• Preoperative Predictor
• Recovery

Kaynakça

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