[患有潜在的类风湿性疾病的患者的关节置换结果]
Dominik Emanuel Holzapfel1, Max Thieme2, Tobias Kappenschneider2
1Medical Center, Department of Orthopaedic Surgery Asklepios Klinikum Bad Abbach, Regensburg University, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Deutschland. dominik.holzapfel@ukr.de.
Zeitschrift fur Rheumatologie
|October 4, 2023
概括
患有风湿性疾病 (RD) 的患者在全关节置换 (TJR) 后面临更高的术后并发症风险. 然而,RD患者获得了类似的结果,有些人在全膝关节置换 (TKR) 后表现出更好的结果.
科学领域:
- 整形外科和风湿病学
- 手术结果研究研究.
- 患者报告的结果衡量结果.
背景情况:
- 人工关节置换为晚期退行性关节疾病提供了显著的好处.
- 风湿性疾病 (RD) 在接受全关节置换 (TJR) 的患者中代表着复杂的并发症.
研究的目的:
- 评估潜在的风湿性疾病对术后并发症的影响.
- 评估患者在选择性全膝关节置换 (TKR) 和全关节置换 (THR) 后报告的结果 (PRO) 在有或没有RD的患者中.
主要方法:
- 对9149名接受选择性TKR或THR的患者进行了回顾性分析.
- 具有和没有RD的患者之间的并发症率和PRO的比较.
- 多变量后勤回归以确定 RD 作为并发症的独立风险因素.
主要成果:
- 患有RD的患者在TJR后出现了增加的医疗并发症 (7.1%对5.2%) 和严重的 (Clavien-Dindo IV级) 并发症 (2.8%对1.8%).
- 手术修复和手术并发症的发生率在各组之间是相似的 (2.5%对2.4%).
- 在TKR后的RD患者中观察到更高的PRO响应率 (91.9%与84.5%),而TKR结果相似 (93.4%与93.2%).
结论:
- 尽管手术后并发症率较高,但患有RD的患者在TJR1年后获得了相似的功能结果.
- 接受TKR的RD患者表现出更高的响应率,表明显著的益处.
- 关节置换是潜在的风湿性疾病患者的可行和有益的治疗选择,即使考虑到他们的脆弱性.
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