대퇴골두 무혈성 괴사증 환자의 체질량 지수가 인공 고관절 전치환술 후 임상적 결과와 삶의 질에 미치는 영향
The Effect of Body Mass Index on Clinical Result and Life Quality after Total Hip Arthroplasty of Patients Who Were Femur Head Avascular Necrosis
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목적: 대퇴골두 무혈성 괴사로 인공 고관절 전치환술을 시행한 환자에서 수술 전 체질량 지수가 수술후 결과 및 삶의 질 변화에 미치는 영향을 알아 보고자 하였다. 대상 및 방법: 2005년 3월부터 2011년 5월까지 대퇴골두 무혈성 괴사로 세라믹-세라믹 관절면 인공고관절 전치환수술 후 2년 이상 추시가 가능하였던 246명을 대상으로 하였다. 체질량 지수에 따라서4군(저체중 군, 정상체중 군, 과체중 군, 비만 군)으로 나누어, Harris hip score, 36-item shortform health survey (SF-36) score, 방사선 검사, 합병증을 비교 하였다. 결과: 정상 체중 군이 가장 좋은 임상결과(94.36±7.51)를 보였으나 통계적 차이가 없었고, 비만 군이 가장 향상된 SF-36 score 결과를 보였다. 합병증은 저체중 군(50%)과 비만 군(19.5%)에서 유의하게 많이 발생 하였고, 특히 인공관절 치환물 주위 골절(P=0.002)과 폐렴(P=0.005)이 저체중 군에서 많이 발생하였다. 결론: 비만 및 저체중이 수술 후 임상 결과에 미치는 영향은 미미하고, 비정상 체질량 지수를 갖는 환자도 수술 후 높은 삶의 질을 기대 할 수 있다.
Abstract
Purpose: This study examined the association between the pre-operative body mass index (BMI) and the post total hip replacement arthroplasty result, as well as postoperative change in the life quality of patients diagnosed with femur head avascular necrosis (AVN). Materials and Methods: Patients diagnosed with femur head AVN undergoing total hiparthroplasty (THA) with a ceramic-ceramic articular surface from March 2005 to May 2011 were analyzed retrospectively. The Harris hip score (HHS), 36-item short-form health survey (SF-36) score, radiological examination, and complications at two years or longer after THA in the 4 groups were analyzed in terms of the BMI (underweight group, normal weight group, overweight group, and obesity group). Results: The normal body weight group showed the best result(94.36±7.51) in all scores but the difference was not significant. In the SF-36 physical scores, obese group showed the greatest improvement. Complications occurred frequently in the underweight(50%) and obese groups(19.5%). In particular, periprosthetic fractures (P=0.002) and pneumonia (P=0.005) occurred frequently in the underweight group. Conclusion: The impacts of obesity and underweight on the clinical outcome after surgery are insignificant but patients with an abnormal BMI can expect a high quality of life after surgery.
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