Nickelas Huffman, Ignacio Pasqualini, Peter Surace, Robert M Molloy, Nicolas S Piuzzi, Matthew E Deren
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引用次数: 0
Abstract
» Emerging evidence suggests the prevalence of crystalline arthropathy (CA) in the setting of total knee arthroplasty (TKA) is increasing, and diagnosis of CA is often intricate because of symptom overlap with other common postoperative complications such as periprosthetic joint infection (PJI). Consequently, an accurate and timely diagnosis becomes pivotal in guiding the choice of treatment.» CA includes gout and calcium pyrophosphate deposition (CPPD) disease, and accurate diagnosis in patients with prior TKA requires a multifaceted approach. The diagnosis algorithm plays a critical role in determining the appropriate treatment approach.» Management of CA typically involves a conservative strategy, encompassing the administration of nonsteroidal anti-inflammatory drugs, colchicine, and steroids, regardless of whether patients have undergone prior TKA.» There is conflicting evidence on the effect CA has on the surgical outcomes in postoperative TKA patients. While these patients may expect excellent functional outcomes and pain relief, they may be at a higher risk of complications such as infections, medical complications, and revision procedures.» Additional research is required to fully comprehend the impact of CA on postoperative TKA outcomes and to establish effective strategies for enhancing patient care and optimizing long-term joint function.
"新的证据表明,全膝关节置换术(TKA)中结晶性关节病(CA)的发病率正在上升,由于症状与假体周围关节感染(PJI)等其他常见术后并发症重叠,CA 的诊断往往错综复杂。因此,准确及时的诊断对于指导治疗方案的选择至关重要"。CA包括痛风和焦磷酸钙沉积症(CPPD),对曾接受过TKA的患者进行准确诊断需要采取多方面的方法。诊断算法在确定适当的治疗方法方面起着至关重要的作用"。CA的治疗通常采用保守策略,包括使用非甾体抗炎药、秋水仙碱和类固醇,无论患者之前是否接受过TKA"。关于 CA 对 TKA 术后患者手术效果的影响,目前存在相互矛盾的证据。虽然这些患者可能期望获得良好的功能效果和疼痛缓解,但他们可能面临更高的并发症风险,如感染、内科并发症和翻修手术"。要全面了解 CA 对 TKA 术后效果的影响,并制定有效的策略来加强患者护理和优化长期关节功能,还需要进行更多的研究。
期刊介绍:
JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.