학술논문
Mid-term improvement of cognitive performance after total hip arthroplasty in patients with osteoarthritis of the hip : a prospective cohort study.
Document Type
Academic Journal
Author
Strahl A; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Kazim MA; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Kattwinkel N; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Hauskeller W; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Moritz S; Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Arlt S; Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Niemeier A; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Source
Publisher: British Editorial Society of Bone & Joint Surgery Country of Publication: England NLM ID: 101599229 Publication Model: Print Cited Medium: Internet ISSN: 2049-4408 (Electronic) Linking ISSN: 20494394 NLM ISO Abbreviation: Bone Joint J Subsets: MEDLINE
Subject
Language
English
Abstract
Aims: The aim of this study was to determine whether total hip arthroplasty (THA) for chronic hip pain due to unilateral primary osteoarthritis (OA) has a beneficial effect on cognitive performance.
Methods: A prospective cohort study was conducted with 101 patients with end-stage hip OA scheduled for THA (mean age 67.4 years (SD 9.5), 51.5% female (n = 52)). Patients were assessed at baseline as well as after three and months. Primary outcome was cognitive performance measured by d2 Test of Attention at six months, Trail Making Test (TMT), FAS-test, Rivermead Behavioural Memory Test (RBMT; story recall subtest), and Rey-Osterrieth Complex Figure Test (ROCF). The improvement of cognitive performance was analyzed using repeated measures analysis of variance.
Results: At six months, there was significant improvement in attention, working speed and concentration (d2-test; p < 0.001), visual construction and visual memory (ROCF; p < 0.001), semantic memory (FAS-test; p = 0.009), verbal episodic memory (RBMT; immediate recall p = 0.023, delayed recall p = 0.026), as well as pain (p < 0.001) with small to large effect sizes. Attention, concentration, and visual as well as verbal episodic memory improved significantly with medium effect sizes over η2 partial = 0.06. In these cognitive domains the within-group difference exceeded the minimum clinically important difference.
Conclusion: THA is associated with clinically relevant postoperative improvement in the cognitive functions of attention, concentration, and memory. These data support the concept of a broad interaction of arthroplasty with central nervous system function. Cite this article: Bone Joint J 2022;104-B(3):331-340.
Methods: A prospective cohort study was conducted with 101 patients with end-stage hip OA scheduled for THA (mean age 67.4 years (SD 9.5), 51.5% female (n = 52)). Patients were assessed at baseline as well as after three and months. Primary outcome was cognitive performance measured by d2 Test of Attention at six months, Trail Making Test (TMT), FAS-test, Rivermead Behavioural Memory Test (RBMT; story recall subtest), and Rey-Osterrieth Complex Figure Test (ROCF). The improvement of cognitive performance was analyzed using repeated measures analysis of variance.
Results: At six months, there was significant improvement in attention, working speed and concentration (d2-test; p < 0.001), visual construction and visual memory (ROCF; p < 0.001), semantic memory (FAS-test; p = 0.009), verbal episodic memory (RBMT; immediate recall p = 0.023, delayed recall p = 0.026), as well as pain (p < 0.001) with small to large effect sizes. Attention, concentration, and visual as well as verbal episodic memory improved significantly with medium effect sizes over η
Conclusion: THA is associated with clinically relevant postoperative improvement in the cognitive functions of attention, concentration, and memory. These data support the concept of a broad interaction of arthroplasty with central nervous system function. Cite this article: Bone Joint J 2022;104-B(3):331-340.