无菌膝关节置换术后围手术期并发症的风险分析

IF 2 3区 医学 Q2 ORTHOPEDICS
Ahmed Abdelghany, Filippo Migliorini, Christian Peterlein, Christian Götze, Julian Koettnitz
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引用次数: 0

摘要

全下肢关节置换术是标准的骨科手术,在现代文明中稳步增加。按比例,翻修性关节置换术的数量和相应的医疗保健系统的经济负担将增加。本文对无菌翻修膝关节置换术后的并发症进行了分析。方法收集122例无菌改良全膝关节置换术患者的资料。该研究收集了住院和随访期间的全身和手术并发症、输血单位以及Hb和CRP水平变化的信息。术前及术后第1、2、4天分别测定Hb和CRP。采用IBM SPSS version 29进行统计分析。结果在系统性、手术相关和输血率以及膝关节置换术改变的原因方面,年龄和性别存在显著差异。在这些患者中,38.5%的患者接受了完整的假体置换,11.5%的患者接受了部分假体置换(股骨或胫骨),30.3%的患者接受了孤立的假体置换,19.7%的患者仅接受了清创。股骨和胫骨松动在75岁以上和初次手术与再次就诊间隔较长的患者中更为常见(p = 0.001)。运动障碍和体位错位患者就诊时间较早(p = 0.02)。长期的高CRP水平与全身并发症、更长的住院时间和延长的手术时间显著相关。结论无菌性膝关节翻修置换术是一项复杂的手术,其围手术期并发症对预后有显著影响。年龄和性别是处理住院和随访期间并发症的关键因素。老年患者,特别是75岁以上的患者,更容易发生无菌性松动,需要量身定制的术前准备。该研究强调了个性化患者护理策略的重要性,以减轻无菌膝关节翻修置换术的风险并改善结果。试验注册:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk analyses for perioperative morbidities after aseptic knee revision arthroplasty

Introduction

Total lower limb arthroplasties are standard orthopedic surgeries that are steadily increasing in modern civilization. In proportion, the number of revision arthroplasties and the corresponding financial burden for healthcare systems will increase. The present clinical investigation analyzed morbidities after aseptic revision knee arthroplasty.

Methods

Data from 122 patients following aseptic revision TKA (total knee arthroplasty) were collected. The study collected information on systemic and surgical complications during hospitalization and follow-up, blood transfusion units, and changes in Hb and CRP levels. Hb and CRP were measured preoperatively and on postoperative days 1, 2, and 4. Statistical analyses were performed using IBM SPSS version 29.

Results

Significant differences were observed in systemic, surgery-related and blood transfusion rates and reasons for knee replacement changes based on age and gender. Of the patients, 38.5% received a full component change, 11.5% received a partial component replacement (either femoral or tibial), 30.3% had an isolated inlay change, and 19.7% underwent debridement only. Femoral and tibial loosening were more frequent in patients over 75 years and those with longer intervals between the initial operation and re-presentation (p = 0.001). Patients with movement deficits and malposition presented earlier for consultation (p = 0.02). Prolonged high CRP levels were significantly correlated with systemic complications, longer hospital stays, and extended operative times.

Conclusions

Aseptic knee revision arthroplasty is a complex procedure with perioperative morbidities that can significantly impact outcomes. Age and gender are crucial factors in managing complications during hospitalization and follow-up. Elderly patients, particularly those over 75 years, are more prone to aseptic loosening and require tailored preoperative preparation. The study underscores the importance of individualized patient care strategies to mitigate risks and improve outcomes in aseptic knee revision arthroplasty.

Trial registration: Not applicable.

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来源期刊
CiteScore
4.30
自引率
13.00%
发文量
424
审稿时长
2 months
期刊介绍: "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).
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