目的了解患者及家属对即将施行的膝关节置换术，术中、术后康复相关诊疗行为等的关注程度。方法对128例即将施行全膝关节置换术的患者及其家属进行术前关注问题的问卷调查。问卷包括61个问题，按关注程度分为1～4级(1＝不关心，2＝有些关心，3＝比较关心，4＝非常关心)。并对结果进行统计学分析。结果124例患者对所有项目的平均关注度是3.11。平均关注度最高的5项是：术后能否行走自如(3.78)，手术医生的经验(3.73)，手术是否会失败(3.68)，人工关节使用寿命(3.63)，术后生活能否自理(3.63)。家属的平均关注度是3.18。家属最关注的5个项目是：手术医生的经验(3.86)，术后能否行走自如(3.82)，术后疼痛缓解是否理想(3.74)，术后关节是否僵硬(3.72)，出院后是否疼痛(3.72)。＜65岁的患者对6个项目(术后能否照看小孩、术后是否可以进行娱乐活动、人工关节使用的寿命、术后能否骑车、术后能否搬抬重物和置换后人工关节周围是否会骨折)的关注度要显著高于≥65岁的患者，老年患者和年轻患者对麻醉意外发生的关注度分别为：3.71、3.38，( P＝0.036)；老年患者和年轻患者对麻醉医师的经验的关注度分别为：3.73、3.47，( P＝0.040)；老年患者和年轻患者对出院后是否疼痛的关注度为：3.70、3.41，( P＝0.048)，麻醉意外、麻醉医师的经验、出院后是否疼痛是老年患者较为关注的3个项目。在所有项目平均关注度上，年龄的差异没有统计学意义(年轻患者和老年患者分别是3.14和3.09，P＝0.624)。结论中国患者在人工全膝关节置换术( total knee arthroplasty，TKA )术前最关注的问题是：术后膝功能的恢复，医生的水平和假体的使用。在术前，中国患者的关注度显著高于西方患者。但与国外患者一样，高屈曲也不是中国患者关注的焦点。相比患者本人，患者家属对术后膝功能恢复的关注程度更高。
Objective To learn about the degree of concerns of Chinese patients and their family about the upcoming total knee arthroplasty ( TKA ), postoperative rehabilitation, expectation and other relevant diagnosis and treatment procedures. Methods 128 patients who were scheduled to undergo TKA and their family members were inquired about preoperative concerns with a 61-question questionnaire. The degree of concerns was assessed by assigning a score on a scale of 1-4 ( 1=not concerned, 2=somewhat concerned, 3=very concerned and 4=extremely concerned ). Collected data were then statistically analyzed. Results The mean score of the degree of concerns of all the patients about all the items was 3.11. The top 5 concerns of Chinese patients were the ability to walk with no difficulties postoperatively ( 3.78 ), surgeons’ experience ( 3.73 ), the risk of failure in the surgery ( 3.68 ), the lifespan of joint prostheses ( 3.63 ) and the ability to take care of oneself postoperatively ( 3.63 ). The mean score of the degree of concerns of their family members was 3.18. The top 5 concerns of family members were surgeons’ experience ( 3.86 ), the ability to walk with no difficulties postoperatively ( 3.82 ), the postoperative pain relief rate ( 3.74 ), the postoperative occurrence of ankylosis ( 3.72 ), pain existing or not after discharge ( 3.72 ). The patients under 65 years old were evidently more concerned about the 6 items than those aged greater than or equal to 65 years old, including the ability to look after children postoperatively, the ability to enjoy recreations postoperatively, the lifespan of joint prostheses, the ability to ride a bike postoperatively, the ability to lift weights postoperatively and the occurrence of fractures around artificial prostheses after TKA. The scores of the degree of concerns of elderly and young patients about the occurrence of anesthetic accident were 3.71 and 3.38 respectively ( P=0.036 ). The scores of the degree of concerns of elderly and young patients about the experience of anesthetists were 3.73 and 3.47 respectively ( P=0.040 ). The scores of the degree of concerns of elderly and young patients about the pain relief rate after discharge were 3.70 and 3.41 respectively ( P=0.048 ). Elderly patients were concerned more about the occurrence of anesthetic accident, the experience of anesthetists and the pain relief rate after discharge than about other items. As to the mean degree of concerns about all the items, the differences in the age were not statistically significant, and the scores of elderly and young patients were 3.14 and 3.09 respectively ( P=0.624 ). Conclusions The top 3 concerns of Chinese patients before TKA are the postoperative functional recovery of the knee, surgeons’ experience, and the use of joint prostheses. Before the surgery, the score of the degree of concerns is higher in Chinese patients than that in western patients. Just like western patients, the ability to perform high-flexion activities is not the main concern of Chinese patients. Family members are more concerned about the postoperative functional recovery of the knee than patients themselves.