吸烟是全踝关节置换术后并发症的风险因素吗？一项荟萃分析。

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-01-01 DOI:10.1016/j.fas.2024.06.009

Yen Thi Thao Le , Duy Nguyen Anh Tran , Bao Tu Thai Nguyen , Tan Thanh Nguyen , Yu-Pin Chen , Yi-Jie Kuo

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引用次数: 0

摘要

背景：长期以来，吸烟一直被认为是影响伤口和骨骼愈合的危险因素，尤其是在踝关节和足部手术中。尽管有许多研究探讨了吸烟与踝关节置换术后并发症之间的关系，但研究结果仍存在很大的不一致性。因此，本荟萃分析研究旨在阐明吸烟是否会增加全踝关节置换术（TAA）后并发症的发生率，为临床管理提供有价值的见解：方法：在PubMed、Embase和Wiley数据库中进行了全面的系统检索，以确定有关吸烟对踝关节置换术后并发症影响的相关英文研究，对发表日期没有任何限制。纳入研究的质量采用纽卡斯尔-渥太华量表进行评估。随机效应模型用于计算几率比（OR）和 95 % 置信区间（CI）。本研究遵守了透明报告的 PRISMA 指南，并在 PROSPERO 注册：分析纳入了 12 项回顾性队列研究的数据，受试者共计 17331 人，其中 2580 人为吸烟者，791 人在 TAA 后出现并发症。研究结果表明，伤口相关并发症在统计学上存在显著差异（OR：2.26；95 % CI：1.13-4.50；P = .02），尤其是当前吸烟者，OR 为 3.30（95 % CI：2.12-5.14；P 结论：吸烟，尤其是当前吸烟与伤口相关并发症的关系非常密切：吸烟，尤其是当前吸烟与全踝关节置换术术后伤口并发症风险增加有关。尽管目前还没有确切的证据表明手术前戒烟的最佳时间，但戒烟似乎是减少这些并发症的谨慎措施。

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Is smoking a risk factor for complications following total ankle arthroplasty? A meta-analysis

Background

Smoking has long been recognized as a risk factor for impaired wound and bone healing, particularly in the context of ankle and foot surgery. Despite numerous studies exploring the association between smoking and complications following ankle replacement, there remains significant inconsistency in their findings. Therefore, this meta-analysis study aims to elucidate whether smoking increases the rate of complications after total ankle arthroplasty (TAA), providing valuable insights for clinical management.

Methods

A comprehensive systematic search was conducted in the PubMed, Embase, and Wiley databases to identify relevant English studies on the influence of smoking on postoperative complications following ankle replacement without any restrictions on publication dates. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Random-effect models were used to calculate odds ratios (OR) and 95 % confidence intervals (CI). This study adhered to PRISMA guidelines for transparent reporting and was registered with PROSPERO.

Results

The analysis incorporated data from 12 retrospective cohort studies, totaling 17331 subjects, 2580 of whom were smokers and 791 complications following TAA. The findings revealed a statistically significant disparity in wound-related complications (OR: 2.26; 95 % CI: 1.13–4.50; P = .02), particularly evident in current smokers with an OR of 3.30 (95 % CI: 2.12–5.14; P < .00001). However, we lacked sufficient evidence to substantiate an association between smoking and complications related to the prosthesis (OR: 1.09; 95 % CI: 0.77–1.53; P = .64) or systemic complications (OR: 1.18; 95 % CI: 0.10–14.13; P = .90) following TAA.

Conclusions

Smoking, especially current smoking, is associated with increased wound complication risk post-operation for total ankle arthroplasty. Despite a lack of definitive evidence on the optimal timeframe for smoking cessation before surgery, discontinuing smoking appears to be a prudent measure to mitigate these complications.

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.