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时间问题:优化手术前减肥的时间框架,以减轻膝盖关节整形手术后的感染风险

Daniel Hameed¹, Sandeep S Bains¹, Jeremy A Dubin¹

¹Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, Maryland.

The Journal of arthroplasty

|December 22, 2023

概括

在全膝关节整形手术 (TKA) 之前至少9个月减肥,可以降低肥胖患者周围假肢关节感染 (PJI) 的风险. 与非肥胖个体相比,等待不到9个月会增加PJI的风险.

科学领域:

整形外科手术整形外科手术
肥胖医学肥胖医学
传染性疾病传染性疾病

背景情况:

在全膝关节整形术 (TKA) 后,致病性肥胖患者面临更高的围假肢关节感染 (PJI) 风险.
目前的指导方针建议TKA的手术前体重指数 (BMI) <40 .
这项研究调查了在TKA之前实现体重减轻的初始BMI为40-50的患者中PJI发生率.

研究的目的:

评估减肥时间对TKA患者PJI风险的影响.
为了比较不同间隔减肥的肥胖患者和非肥胖群体之间的PJI率.

主要方法:

对一级TKA患者的国家全付费者数据库 (PearlDiver) 的回顾性审查.
患者的分层 (BMI 40-50) 通过BMI降至<35在3,3-6,6-9和TKA前9-12个月.
与手术当天BMI为40-50的患者和非肥胖BMI为20-30的队列进行比较;一年多变量分析.

主要成果:

与BMI20-30队列 (P<.001) 相比,在TKA前减肥<9个月的患者中观察到增加的PJI风险.
在TKA前9-12个月减肥的患者与非肥胖队列 (P = .400) 之间,没有发现PJI风险的显著差异.

结论:

在TKA之前至少9个月应该减轻体重,以减轻感染风险.
这些发现对于接受TKA的肥胖患者的手术决策至关重要.
优化减肥时间可以改善结果并减少并发症.

关键词:

这就是为什么BMI是BMI.感染感染的感染.肥胖肥胖肥胖肥胖肥胖肥胖肥胖肥胖整体膝关节关节整形手术减肥减肥减肥减肥减肥减肥

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