Zusammenfassung
Fragestellung: Ziel der Studie ist es, kurzfristige Veränderungen des generischen und krankheitsspezifischen Gesundheitszustandes nach Hüft-TEP-Implantation zu erforschen. Methodik: Bei 21 Patienten mit primärer Koxarthrose wurde präoperativ und drei Monate postoperativ der allgemeine (SF-36) und der krankheitsspezifische (WOMAC) Gesundheitsstatus abgefragt. Nach der Operation absolvierten alle Studienteilnehmer eine 3-wöchige stationäre Rehabilitation in einer zugelassenen Rehabilitationsklinik. Ergebnisse: In allen Subskalen des SF-36 zeigte sich eine Verbesserung des allgemeinen Gesundheitsstatus, in vier der acht Dimensionen waren die Zuwächse statistisch signifikant. Von dem alters- und geschlechtsadjustierten Populationsdurchschnitt blieben die Ergebnisse jedoch deutlich entfernt. Ferner waren in allen drei WOMAC-Dimensionen Verbesserungen zu verzeichnen, wobei in der Schmerzskala die deutlichsten, in der Funktionsskala die geringsten Veränderungen festgestellt wurden. Schlussfolgerungen: Es wurden positive Effekte nach der Hüft-TEP-Implantation und stationärer Rehabilitation in allen Messdimensionen festgestellt. Ob diese jedoch ausschließlich auf die Intervention zurückzuführen sind, ließe sich nur mit einem kontrollierten Studiendesign beantworten. Es muss ferner geprüft werden, inwieweit die Patienten das erreichte Ergebnis über längere Zeit halten können.
Generic and specific health-related quality of life at short-term follow-up after total hip arthroplasty and inpatient rehabilitation program
Purpose: To evaluate short time changes of generic and disease-specific health status after total hip arthroplasty and an in-patient rehabilitation. Patients and Methods: SF-36 and WOMAC were administered to 21 consecutive patients with osteoarthritis of the hip preoperatively and 3 months postoperatively. After discharge from the university hospital all the participants underwent an in-patient rehabilitation program of 3 weeks duration. Results: The follow-up date shows an improvement in all 8 scales of the SF-36 with statistically significant changes in 4 of them. However, the patients did not achieve a gender- and age-adjusted population norm. Furthermore, positive changes in disease-specific health status could be found throughout all subscales of the WOMAC. Conclusions: Improvement in both generic and specific health related quality of life could be shown after total hip arthroplasty and in-patient rehabilitation. A controlled study is needed to prove the specificity of these effects. An other question is, whether the patients are able to hold the achieved results over time.
Schlüsselwörter
Gesundheitsstatus - Koxarthrose - Hüft-TEP - SF-36 - WOMAC
Key words
Health-related quality of life - osteoarthritis - total hip arthroplasty - SF-36 - WOMAC
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Dr. med. Pawel Bak
Institut für Physiotherapie Friedrich-Schiller-Universität Jena
Kollegiengasse 9
07740 Jena
Email: pbak@mti-n.um-jena.de