Toby Jennison, Obioha C Ukoumunne, Sallie Lamb, Ian Sharpe, Andy Goldberg
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引用次数: 0
摘要
背景:尽管踝关节置换术的数量不断增加,但对于哪些患者应该接受踝关节置换术仍存在争议,而且分析踝关节置换术失败风险因素的研究也很有限。本研究的主要目的是分析全踝关节置换术失败的风险因素:方法:结合国家关节登记处(NJR)数据和英国国家医疗服务系统(NHS)数字数据,进行了一项数据关联研究。失败的主要结果是指植入装置的任何组件被移除或更换。Kaplan-Meier 生存图用于说明存活率。多变量考克斯比例危害回归模型用于分析失败或踝关节置换的潜在风险因素:总体5年存活率为90.2%(95% CI为89.2%-91.1%)。在多变量(调整后)Cox 回归模型中,只有年龄(危险比 [HR] 0.96,95% CI 0.94-0.97)、体重指数(BMI;HR 1.03,95% CI 1.01-1.06)和潜在病因(HR 0.88,95% CI 0.80-0.97)与失败风险增加有关:本研究表明,年轻患者和体重指数(BMI)增加的患者踝关节置换术失败的风险增加。我们还发现,类风湿患者的存活率高于骨关节炎患者:证据等级:III级,回顾性队列研究。
Risk Factors for Failure of Total Ankle Replacements: A Data Linkage Study Using the National Joint Registry and NHS Digital.
Background: Despite the increasing numbers of ankle replacements, there remains debate about which patients should undergo an ankle replacement, and there are limited studies analyzing risk factors for failure of an ankle replacement. The primary aim of this study is to analyze the risk factors for failure of total ankle replacements.
Methods: A data linkage study combining the National Joint Registry (NJR) Data and NHS (National Health Service) Digital data was performed. The primary outcome of failure is defined as the removal or exchange of any components of the implanted device. Kaplan-Meier survival charts were used to illustrate survivorship. Multivariable Cox proportional hazards regression models were fitted to analyze potential risk factors for failures or ankle replacements.
Results: The overall 5-year survival was 90.2% (95% CI 89.2%-91.1%). In multivariable (adjusted) Cox regression models, only age (hazard ratio [HR] 0.96, 95% CI 0.94-0.97), body mass index (BMI; HR 1.03, 95% CI 1.01-1.06), and underlying etiology (HR 0.88, 95% CI 0.80-0.97) were associated with an increased risk of failure.
Conclusion: This study demonstrates that younger patients and those with an increased BMI have an increased risk of failure of a primary ankle replacement. We also show that rheumatoid patients have higher survivorship than those with osteoarthritis.
Level of evidence: Level III, retrospective cohort study.
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