肥胖严重程度与膝关节关节整形术后早期重新干预的速度,时间或侵入性无关
Daniel A Driscoll1, Jacqueline Grubel1, Justin Ong1
1Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York.
The Journal of arthroplasty
|March 1, 2024
概括
肥胖类别不会影响全膝关节整形术 (TKA) 后的重新手术率. 这项研究发现,世界卫生组织 (WHO) 的肥胖类别与早期TKA重新干预风险,时间或侵入性之间没有联系.
科学领域:
- 整形外科手术 整形外科手术
- 肥胖医学 肥胖医学
- 生物统计学 生物统计学
背景情况:
- 体重指数 (BMI) 截止值通常用于确定肥胖个体的全膝关节整形术 (TKA) 的资格.
- 不同程度的肥胖与TKA后早期重新手术的风险之间的关联仍然不清楚.
- 这项研究调查了世界卫生组织 (WHO) 肥胖类与TKA后一年内重新干预的可能性,严重程度和时间之间的关系.
研究的目的:
- 确定更高的世卫组织肥胖类是否与TKA后重新手术的风险增加有关.
- 分析肥胖严重程度对早期重新干预的时间和侵入性的影响.
- 评估基于BMI的限制在肥胖患者中对TKA指示的有效性.
主要方法:
- 2016年至2021年期间,对8,674名BMI≥30的患者进行了回顾性审查,这些患者在骨关节炎中接受了一次性单边TKA治疗.
- 患者被分为世卫组织肥胖类I,II和III.
- 回归分析确定了与重新干预率,时间和侵入性相关的因素.
主要成果:
- 一年内整体重新干预率为1.8% (158名患者).
- 在I,II和III类肥胖症中,再干预率分别为1.8%,2.0%和1.4%,没有统计学上显著的差异 (P = .3).
- 糖尿病 (OR = 2.47) 与重新干预有关;非高加索种族 (OR = 1.7) 和更高的查尔森并发症指数 (OR = 2.1) 与更早的重新干预有关.
结论:
- 世界卫生组织 (WHO) 的肥胖类别与TKA后重新干预的速度,时间或侵入性无关.
- 这些发现表明,单独基于BMI的限制可能在预防肥胖患者TKA后的早期重新手术方面具有有限的有效性.
- 糖尿病等并发症和患者因素,如种族和并发症指数,似乎比肥胖类本身对早期重新干预结果的影响更大.
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