全关节整形:肥胖是否重要?
Billy I Kim1, Albert T Anastasio1, Colleen M Wixted1
1Duke University Department of Orthopaedic Surgery, Durham, NC, USA.
Foot & ankle international
|June 22, 2023
概括
肥胖并没有增加关节整形术 (TAA) 后的并发症率. 然而,肥胖患者在TAA后报告了更糟糕的功能结果和生活质量,尽管BMI组的PRO改善类似.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 患者报告的结果
背景情况:
- 有限的数据存在于肥胖对关节整形术 (TAA) 结果的影响,特别是患者报告的结果 (PRO).
- 评估肥胖对TAA并发症率和PRO的影响对于临床决策至关重要.
研究的目的:
- 为了评估肥胖的影响,按BMI分层,在初级TAA后的并发症率上.
- 为了确定肥胖对TAA后患者报告结果 (PRO) 的影响.
主要方法:
- 对1093个初级TAA程序 (2001-2020年) 的回顾性分析,至少2年后续.
- 患者被分为控制 (BMI 18.5-29.9),肥胖类I (BMI 30.0-34.9) 和肥胖类II (BMI >35.0) 组.
- 使用统计分析对人口统计数据,并发症和PRO进行比较,包括植入失败风险的多变量考克斯回归.
主要成果:
- 在BMI类之间没有观察到术后并发症 (感染,植入物失败,入) 的显著差异.
- 肥胖II类患者在手术前表现出较低的足部和脚结局分数疼痛和ADL子表.
- 在最后的随访中,无论是I类还是II类肥胖者,与对照人群相比,他们报告的肌肉骨功能简短评估和36项简短形式健康调查得分都更差.
结论:
- 中期随访表明,肥胖与TAA后并发症率的增加无关.
- 肥胖患者在TAA后经历了肌肉骨功能下降和整体生活质量下降.
- 在BMI类别中没有注意到PRO的差异性改善,这表明肥胖不会不成比例地阻碍恢复进展.
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