Dong-Oh Lee, Ye Jin Jeon, Gil Young Park, Dong Yeon Lee
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引用次数: 0
Abstract
Background: It is unknown whether perioperative bisphosphonate (BP) use reduces revision rates in total ankle replacement arthroplasty (TAR) although its effect has been demonstrated to be effective in reducing revision rates in total knee or hip replacement arthroplasty.
Methods: We reviewed National Health Insurance Service data based on national health insurance service claims data and health care utilization, health screening, sociodemographic variables, medication history, operation codes, and mortality data for 50 million Koreans. From 2002 to 2014, 6391 of 7300 patients who underwent TAR were BP nonusers, whereas 909 patients were BP users. The revision rate according to BP medication and comorbidities was investigated. The Kaplan-Meier estimate and extended Cox proportional hazard model were also used.
Results: The revision rate of TAR was 7.9% for BP users and 9.5% for BP nonusers, which showed no significant difference (P = .251). Implant survival over time decreased constantly. Adjusted hazard ratio for hypertension was 1.242 (P = .017), whereas other comorbidities such as diabetes had no effect on the revision rate of TAR.
Conclusion: We found that the perioperative BP use did not reduce the revision rate of TAR. Comorbidities (except hypertension) did not affect the revision rate of TAR. More research regarding various factors affecting the revision of TAR could be warranted.
Level of evidence: Level III, retrospective cohort study.
背景：围手术期使用双膦酸盐（BP）是否能降低全踝关节置换术（TAR）的翻修率尚属未知，尽管其效果已被证实能有效降低全膝关节或髋关节置换术的翻修率：我们根据国民健康保险服务索赔数据和 5000 万韩国人的医疗保健使用情况、健康检查、社会人口变量、用药史、手术代码和死亡率数据，对国民健康保险服务数据进行了审查。从2002年到2014年，7300名接受TAR的患者中有6391名未使用降压药，而909名患者使用了降压药。研究人员根据血压药物和合并症调查了复查率。研究还使用了卡普兰-梅耶估计和扩展的考克斯比例危险模型：结果：服用降压药的患者的TAR翻修率为7.9%，未服用降压药的患者的翻修率为9.5%，两者无显著差异（P = .251）。随着时间的推移，植入物的存活率不断下降。高血压的调整危险比为1.242（P = .017），而糖尿病等其他合并症对TAR的翻修率没有影响：结论：我们发现，围手术期使用降压药并不会降低 TAR 的翻修率。结论：我们发现，围手术期使用降压药并不会降低 TAR 的翻修率，合并症（高血压除外）也不会影响 TAR 的翻修率。有必要对影响TAR翻修的各种因素进行更多研究：证据等级：三级，回顾性队列研究。
期刊介绍：
Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers.
The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008.
The journal focuses on the following areas of interest:
• Surgery
• Wound care
• Bone healing
• Pain management
• In-office orthotic systems
• Diabetes
• Sports medicine
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