苏格兰整形外科和创伤委员会成员对病态肥胖患者下肢关节置换术的调查。

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-02-01 DOI:10.1016/j.jcot.2024.102855

Alexis Panzures , Nick D. Clement , Paul Jenkins , Muhammad Adeel Akhtar

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引用次数: 0

摘要

背景：苏格兰是发达国家中肥胖率最高的国家之一，这增加了下肢骨关节炎导致全关节置换术（TJA）的风险。本文旨在调查(1)苏格兰骨科顾问管理肥胖患者终末期髋关节和膝关节骨关节炎的现状，(2)对国家指南的遵守情况，以及(3)对BMI≥40的下肢TJA并发症风险的了解。方法：在2023年2月至3月期间，向苏格兰骨科与创伤委员会（SCOT）的所有活跃成员发送了一份包含15个问题的在线调查，以了解目前管理需要关节置换手术的肥胖下肢关节炎患者的做法。结果：调查收到了来自SCOT成员的62份回复。顾问级别的经验为1至44年（平均15年）。61%的应答者知道SCOT关于肥胖患者下肢TJA的国家指南。72%的医生会给BMI指数为bbb的患者提供TJA， 40.35%的医生会征求第二意见，22%的医生会在多学科小组会议上讨论这些病例。71%的人知道当地的体重管理指南。在病态肥胖患者中，77%的人认为深度感染的风险在1%到30%之间，40%的人认为截肢的风险在0.002%到10%之间。结论：苏格兰肥胖下肢骨关节炎患者的手术治疗方法多种多样。标准化的做法将有利于获得知情同意。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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A survey of Scottish Committee for Orthopaedics and Trauma members on lower limb joint replacement practices in morbidly obese patients

Background

Scotland has one of the highest rates of obesity in the developed world which increases risk of lower limb osteoarthritis resulting in total joint arthroplasty (TJA). This paper aimed to investigate (1) current practice of orthopaedic consultants in Scotland in managing end-stage hip and knee osteoarthritis in obese patients, (2) adherence to National guidelines, and (3) understanding of complication risks in lower limb TJA for BMI≥40.

Methods

A 15-question online survey was sent to all active members of Scottish Committee for Orthopaedics and Trauma (SCOT) between February and March 2023 to understand the current practices for managing obese patients with lower limb arthritis requiring joint replacement surgery.

Results

The survey received 62 responses from members of SCOT. The experience ranges from 1 to 44 years (mean 15 years) at consultant level. 61 % of respondents were aware of the SCOT National Guidelines for lower limb TJA in obese patients. 72 % would offer TJA to patients with a BMI>40.35 % would get a second opinion and 22 % discuss these cases in a multidisciplinary team meeting. 71 % were aware of the local weight management guidelines. 77 % quoted risk of deep infection to be between 1 and 30 %, and 40 % quoted risk of amputation between .002 % and 10 % in morbidly obese patients.

Conclusion

Surgical management of obese patients with lower limb osteoarthritis in Scotland is variable. A standardised approach would be beneficial in obtaining informed consent.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.