肥胖对全膝关节置换术结果的影响:系统回顾

A. Lengkong
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引用次数: 0

摘要

治疗晚期膝关节炎的一种常见矫形手术是全膝关节置换术(TKA)。肥胖的定义是体重指数大于或等于 30 kg/m2,这可能会对术后问题产生影响。通过比较多因素匹配的肥胖者和非肥胖者,我们研究了某些问题的发生率、翻修率和 TKI 术后护理费用。我们预测,肥胖患者的治疗效果会比不胖的患者差。肥胖与急性肾损伤、深静脉血栓、尿路感染和阿片类药物使用等内科并发症的发生率较高有关,但与贫血、心律失常、心脏骤停、肺炎和输血的发生率明显较低有关。手术并发症包括伤口并发症、手术部位感染、翻修需求以及 TKA 一年后较高的总体护理成本。肥胖患者的处方治疗费用也大大降低。与类似的非肥胖者相比,肥胖者的治疗效果并没有天生差。不过,由于肥胖症的发病率预计会继续上升,了解 TKA 术后可能出现的问题有助于让患者了解手术可能带来的危险,并指导外科医生为患者提供护理。因此,为了创造新的治疗方法,未来的研究应该关注导致这些问题的潜在过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Obesity on Total Knee Arthroplasty Outcomes: A Systematic Review
One frequent orthopaedic procedure for treating advanced knee arthritis is total knee arthroplasty, or TKA. Obesity is defined as a body mass index of 30 kg/m2 or greater, and it might have an impact on post-operative problems. Comparing multifactor matched obese and non-obese individuals, we look at the incidence of certain problems, revision rates, and post-TKI care expenses. We predict that patients who are obese will experience worse outcomes than those who are not fat. Obesity was linked to higher rates of medical complications like acute kidney injury, deep vein thrombosis, urinary tract infection, and opioid use, but significantly lower rates of anemia, arrhythmia, cardiac arrest, pneumonia, and transfusion. Surgical complications included wound complications, surgical site infections, need for revision, and higher overall cost of care one year after TKA. Patients who were obese also had far reduced prescription expenditures for treatment. When compared to similar non-obese individuals, the outcomes for obese people were not inherently poorer. However, as obesity is expected to continue rising in prevalence, knowing the problems that might occur after TKA can help inform patients about possible dangers from surgery and direct surgeons in providing care for their patients. Therefore, in order to create new treatments, future research should look at the underlying processes that lead to these issues.
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