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我们是否应该向患者推带骨关节修复术?

Martinique Vella-Baldacchino¹, Jeremy Webb², Bhavana Selvarajah²

¹MSk Lab, Imperial College London, Department of Surgery & Cancer, Sir Michael Uren Hub, London, UK.

Bone & joint open

|December 14, 2023

概括

关节整形术 (PFA) 和全膝关节整形术 (TKA) 是关节关节骨关节炎 (PFJ OA) 的可行的选择. 在手术后,PFA提供了更好的运动范围,并发症没有显著差异.

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
康复医学是康复的医学.

背景情况:

关节骨关节炎 (PFJ OA) 影响高达40%的患者.
手术的选择包括膝盖骨关节整形手术 (PFA) 或全膝关节整形手术 (TKA).
患者报告的结果测量 (PROM) 对于评估治疗成功至关重要.

研究的目的:

为了比较第二代PFA的术后成功与PFJ OA的TKA,OA.
用PROM和患者重要的领域来评估结果.
为 PFJ OA 治疗的临床决策提供信息.

主要方法:

在MEDLINE,EMBASE,CINAHL和EBSCO的系统文献搜索到2022年1月.
包括使用PFA或TKA治疗初级PFJOA的研究 (≥18年,≥30天随访).
排除创伤次要的OA;使用ROB-2和ROBINS-I工具进行偏差评估.

主要成果:

包括9项研究 (4项RCT,5项队列研究).
在PFA和TKA之间,PROM或膝关节功能得分没有显著差异.
并发症发生率没有显著差异;PFA显示手术后运动范围有所改善.

结论:

两种TKA和PFA都是有效的治疗初级PFJOA.
对患者满意度和生活质量的重视越来越大.
在建议为PFJ OA牺牲健康的膝盖区之前,需要进一步考虑.

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