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Total Diz Artroplastisi Yapılan Hastaların Taburculuk Öncesi Ağrı, Fonksiyonel Durum, Anksiyete ve Depresyon Düzeylerinin İncelenmesi

Amaç: Çalışmamızın amacı; total diz artroplastisi yapılan postoperatif erken dönemdeki hastaların; taburculuk öncesi ağrı, fonksiyonel durum, anksiyete-depresyon düzeylerini incelemekti. Materyal ve Metot: Retrospektif çalışmamıza 60-85 yaş aralığındaki 58 hasta katıldı. Hastaların takip dosyalarından; fiziksel özelliklerine, ağrı şiddetlerine, fonksiyonel durumlarına ve anksiyete-depresyon düzeylerine ilişkin verileri kullanıldı. Bulgular: Olguların cinsiyetlerine göre ölçüm skorları karşılaştırıldığında ağrı ve fiziksel fonksiyon parametrelerinde istatistiksel olarak anlamlı fark bulunmadı (p:0.49; p:0,20). Hastane anksiyete ve depresyon düzeyleri karşılaştırıldığında, kadınların erkeklere göre daha yüksek skor aldığı saptandı (p:0,00). Olguların ağrı şiddetleriyle diz skoru arasında anlamlı ilişki bulunmazken; anksiyete-depresyon düzeyleriyle arasında pozitif yönlü-orta düzeyde ilişki olduğu görüldü (r1:0,520, r2:0,514; p<0,01). Diz skoruyla anksiyete-depresyon düzeyleri arasındaysa negatif yönlü-orta düzeyde bir ilişki olduğu bulundu (r1:-0,469, r2: -0,482; p<0,01). Sonuç: Çalışmamızın sonuçları, olguların fiziksel ve psikolojik durumlarının ilişkili olduğunu gösterdi. Hastaların taburculuk öncesi postoperatif erken dönemde, her iki parametrenin de göz önünde bulundurularak değerlendirilmesi; hastaların taburculuk sonrası takiplerinde etkin rol oynayarak başarılı bir hastalık yönetim süreci sağlayacaktır.

Anahtar Kelimeler:

Disfonksiyon, diz protezi, osteoartrit

Investigation of Pain, Function, Anxiety, and Depression Levels in Patients with Total Knee Arthroplasty Before Discharge

Objective: We aimed to investigate the pain, function, and anxiety-depression levels in patients who had undergone total knee arthroplasty (TKA) in the early postoperative period. Materials and Methods: Fifty-eight patients between the ages of 60-85 with TKA were included. From the follow-up files of the patients, data on physical characteristics, pain intensity, function, and anxiety-depression levels were used. Results: When the measurement scores were compared according to gender, no statistically significant difference was found in pain (p:0.49) and physical function (p:0.20). When anxiety-depression levels were compared, it was found that females got higher scores than males (p:0.00). While there was no significant relationship between the pain and knee scores; it was found that there was a moderate positive correlation between pain and anxiety-depression levels (r1:0.520, r2:0.514; p<0.01). There was a statistically significant moderate negative correlation between knee scores and anxiety-depression levels (r1:-0.469, r2:-0.482; p<0.01). Conclusions: This study showed that the physical and psychological states are interrelated. Evaluation in the postoperative period by considering both parameters; will provide a successful disease management process by playing an active role in the follow-up of patients.

Keywords:

Dysfunction, knee prosthesis, osteoarthritis,

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1. Shah K, Zhao AG, Sumer H. New approaches to treat osteoarthritis with mesenchymal stem cells. Stem Cells Int. 2018;2018:5373294. doi:10.1155/2018/5373294
2. Supe I, Supoņenkovs A, Platkâjis A, Kadiša A, Lejnieks A. Detecting knee cartilage structural changes using magnetic resonance computed vision analysis in patients with osteoarthritis: Preliminary results. In Proc. Latv. Acad. Sci, Sect B: B Nat Exact Appl Sci. 2021;75(1):47-51. doi:10.2478/prolas-2021-0008
3. Götz JS, Benditz A, Reinhard J, et al. Influence of anxiety/depression, age, gender and asa on 1-year follow-up outcomes following total hip and knee arthroplasty in 5447 patients. J Clin Med. 2021;10(14):3095. doi:10.3390/jcm10143095
4. Wu J, Qian Z, Xu R, et al. Association between pain in knee osteoarthritis and mechanical properties of soft tissue around knee joint. IEEE Access. 2021;9:14599-14607. doi:10.1109/ACCESS.2021.3050776
5. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994;84(3):351-358. doi:10.2105/ajph.84.3.351
6. Scopaz KA, Piva SR, Wisniewski S, et al. Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Arch Phys Med Rehabil. 2009;90(11):1866-1873. doi:10.1016/j.apmr.2009.06.012
7. Aydemir O. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Turk Psikiyatri Derg. 1997;8:187-280.
8. Doury-Panchout F, Metivier J, Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2014;51(2):155-161.
9. Güney H, Kınıklı Gİ, Karahan S, Çağlar O, Atilla B, Yüksel İ. The relationship between kinesiophobia and early functional and physiological outcomes in patients with total hip and knee arthroplasty. J Occup Ther Rehab. 2016;4(2):97-101.
10. Oflaz F, Vural H. Yatan hastaların anksiyete ve depresyon düzeyleri ve ilişkili faktörlerin incelenmesi. Med J SDU. 2010;17(1):1-7.
11. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38(6):633-638. doi:10.1067/mem.2001.118863
12. Narin S, Unver B, Bakirhan S, Bozan O, Karatosun V. Hospital for Special Surgery (HSS) diz skorunun Türkçe versiyonunun kültürel adaptasyonu, güvenilirlik ve geçerliliği. Acta Orthop Traumatol Turc. 2014;48(3):241-248. doi:10.3944/AOTT.2014.3109
13. Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58:754-765.
14. Karamustafalıoğlu O, Bakım B, Ceylan YC, Yavuz BG, Güven T, Gönenli S. İntiharı öngörebilecek bir araç: Hastane Anksiyete ve Depresyon Ölçeği. Dusunen Adam. J Psychiatry Neurol Sci. 2010;23(3):151-157. doi:10.5350/DAJPN2010230302
15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70. doi:10.1111/j.1600-0447.1983.tb09716.x
16. Nandi M, Schreiber KL, Martel MO, Cornelius M, Campbell CM, Haythornthwaite JA, et al. Sex differences in negative affect and postoperative pain in patients undergoing total knee arthroplasty. Biol Sex Differ. 2019;10(1):23. doi:10.1186/s13293-019-0237-7
17. Sanchez-Santos MT, Garriga C, Judge A, et al. Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery. Sci rep. 2018;8(1):1-9. doi:10.1038/s41598-018-21714-1
18. Stundner O, Kirksey M, Chiu YL, et al. Demographics and perioperative outcome in patients with depression and anxiety undergoing total joint arthroplasty: a population-based study. Psychosomatics. 2013;54(2):149-157. doi:10.1016/j.psym.2012.08.009
19. Lo LWT, Suh J, Chen JY, et al. Early postoperative pain after total knee arthroplasty is associated with subsequent poorer functional outcomes and lower satisfaction. J Arthroplasty. 2021;36(7):2466-2472. doi:10.1016/j.arth.2021.02.044
20. Birch S, Stilling M, Mechlenburg I, Hansen TB. The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty. BMC Musculoskelet Disord. 2019;20(1):1-8. doi:0.1186/s12891-019-2787-6
21. Wylde V, Beswick AD, Dennis J, Gooberman-Hill R. Post-operative patient-related risk factors for chronic pain after total knee replacement: a systematic review. BMJ Open. 2017;7(11):e018105. doi:10.1136/bmjopen-2017-018105
22. Gaffney CJ, Pelt CE, Gililland JM, Peters CL. Perioperative pain management in hip and knee arthroplasty. Orthop Clin. 2017;48(4):407-419. doi:10.1016/j.ocl.2017.05.001
23. Xu J, Twiggs J, Parker D, Negus J. The association between anxiety, depression, and locus of control with patient outcomes following total knee arthroplasty. J Arthroplasty. 2020;35(3):720-724. doi:10.1016/j.arth.2019.10.022
24. Kılınç H. Diz osteoartritli hastalarda fiziksel aktivite düzeyi ile ilişkili faktörlerin incelenmesi. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi. Ankara, Türkiye. 2018.
25. World Health Organization. Basic documents 2020. https://apps.who.int/gb/bd/pdf_files/BD_49th-en.pdf. Accessed July 26, 2022.
26. Türkiye Psikiyatri Derneği. Ruh sağlığını güçlendirme: Kavramlar, Kanıtlar, Uygulamalar 2020. https://tpdyayin.psikiyatri.org.tr/BookShopData/th_202003171807228.pdf. Accessed July 26, 2022.
27. Alattas SA, Smith T, Bhatti M, Wilson-Nunn D, Donell S. (2017). Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25(11):3403-3410.
28. Moyer R, Ikert K, Long K, Marsh J. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS reviews. 2017;5(12):e2. doi:10.2106/JBJS.RVW.17.00015
29. Sorel JC, Overvliet GM, Gademan MGJ, den Haan C, Honig A, Poolman RW. The influence of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty. Rheumatol Int. 2020;40(12):1961-1986.