| Objective:Knee Osteoarthritis(KOA)is a chronic disease which may cause pain and dysfunction of the knee due to damage to cartilage and meniscus.This disease occurs more frequently in middle-aged and elderly population and is more common in women.Pain and dysfunction of the knee are often seen in patients with KOA.Pain is one important inducement and predictor of depression.Knee dysfunction often leads to loss of life quality.Therefore,patients with KOA are more likely to develop depression and other mental states than normal people.Total Knee Arthroplasty(TKA)is the primary treatment for severe KOA.With the continuous improvement of surgical skills,the number of KOA patients who underwent TKA increases year by year.TKA replaces the damaged knee joint and alleviates pain,improves function of the knee,thus improves the life quality.Some studies were designed to reveal how mental states affect the outcomes of TKA.However,study about how TKA affects the depression of patients are still rare.Studies also found that,serum level of 5-hydroxytryptamine(5-HT)declines in patients with depression.Therefore,the serum level of 5-HT is a indicator of depression.In recent years,more and more studies were performed aiming the relationship between TKA and mental state of KOA patients.The purpose of this study is to explore if TKA would affect the depression state of KOA patients.Paitnets with KOA who planned to accept TKA were recruited for this study.The HAMD scores,level of 5-HT and VAS were measured before and after surgery at different time,in order to evaluate the depression state of patients.Further,to study how TKA affects the depression state,in order to provide references for clinicMethods:From January 2017 to October 2017,32 patients who met the inclusive criteria were recruited for this study.The inclusive criteria are as below,1.Diagnosed KOA.2.Unilateral TKA;3.Age of patients is elder than or equal to 60 years;Exclusion criteria are as below,1.Bilateral TKA;2.Other operations during the perioperative period;3.A history of apparent trauma,serious diseases,surgery and social problems in the last month before surgery;4.Coronary heart disease,tumor and chronic infection;5.A history of mental disease,or psychotropic drugs taken experience or drug addiction;6.Refuse to cooperate with this study.Baseline data were recorded and HAMD scale scores were completed at 3 weeks before surgery.Serum 5-hvdroxytryptamine(5-HT)levels were tested at 3 weeks before surgery.After unilateral TKA,HAMD scale score and serum 5-HT level were measured at 3 weeks after surgery,2 months after surgery,and 3 months after surgery.The difference was further analyzed by statistical test.Results:The mean scores of HAMD at different time points were as below,7.81±2.81(3W before TKA),7.75±2.06(3W after TKA).7.75±2.27(2M after TKA)and 4.84±2.02(3M after TKA).There were statistically significant differences between the groups(F=12.765 P<0.001).The results of snk-q test indicated that there was a statistical decline of HAMD score at 3 months after surgery.The levels of 5-HT were as below,261.31±16.43 ng/L(3W before TKA),260.63±17.29 ng/L(3W after TKA),258.50±17.53 ng/L(2M after TKA),364.06±18.85 ng/L(3M after TKA).There were statistically significant differences between the two groups(F=280.78 P<0.001).The results of snk-q test indicated that the serum 5-HT concentration level significantly elevated at 3 months after TKA.The VAS pain scores were as below 5.69±0.90(3W before TKA),5.34±0.97(3W after TKA),5.13±0.98(2M after TKA),3.53±1.1 1(3M after TKA).There is statistical differences between groups(F=29.1,P<0.001).The results of snk-q test indicated that the VAS pain score of the knee joint statistically declined at 3 months after surgery.Conclusion:For patients with end-stage knee osteoarthritis,total knee arthroplasty may relieve the depression of patients at 3 months after surgery. |
PDF Full Text Request