在第一阶段的间隔器中,减少了骨骨折和骨部位突起,用骨部件替换
Joshua P Rainey1, Brenna E Blackburn1, Zachary J Moore1
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
The Journal of arthroplasty
|March 3, 2024
概括
在第一阶段的修复膝关节整形术中更换膝关节部件可以减少膝关节骨折并改善膝关节的运动范围. 这种方法可能会增加患者的满意度,尽管再感染率保持不变.
科学领域:
- 整形外科手术 整形外科手术
- 关节整形修复复术修复
- 传染性疾病传染性疾病.
背景情况:
- 周围假肢关节感染是全膝关节整形术 (TKA) 后的一个严重并发症.
- 两阶段修订是感染TKA的常见治疗方法.
- 在第一阶段的修订过程中,讨论了状元件管理的作用.
研究的目的:
- 评估在第一阶段的修订过程中取代骨部件对结果的影响.
- 为了在第一阶段的修订中比较患有和没有轮部件置换的患者之间的结果.
主要方法:
- 139名接受第一阶段修改TKA的患者的回顾性审查.
- 患者被分为两组:没有替代的状元件切除 (n=91) 和状元件替代 (n=48).
- 测量结果包括骨骨折,再感染,膝盖运动范围 (ROM),骨稳定性和患者满意度.
主要成果:
- 骨部件更换与明显较少的骨骨折 (2.1%对12.1%) 和较少的侧面骨位移 (1.7毫米对16.0毫米) 相关.
- 在替代组中,在第一阶段后6周观察到改善的膝盖ROM (+5.9° vs. -11.4°).
- 替代组的患者满意度更高,45.8%的人拒绝第二阶段的修订,而非替代组的患者满意度为3.3%. 两组之间没有发现重感染率的显著差异.
结论:
- 在第一阶段修订TKA期间更换骨部件可以降低骨折和骨突变的发生率.
- 这一策略改善了膝盖早期的运动范围,并可能提高患者的满意度.
- 再感染率在第一阶段的修订中不会受到 patelar 组件更换的不利影响.
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