基于比较国际注册数据的证据,证实了水泥TKA和THA的存在
Martina Humez1, Katharina Kötter2, Ralf Skripitz3
1Institute of Hygiene and Environmental Medicine, Justus-Liebig-Universität Giessen, Schubertstraße 81, 35392, Giessen, Germany. martina.humez@mikrobio.med.uni-giessen.de.
Orthopadie (Heidelberg, Germany)
|April 3, 2024
概括
在老年患者的膝关节置换和部茎中,建议使用带有抗生素的骨水泥进行固固定. 这种方法降低了修复风险和感染率,改善了植入物存活率和患者的结果.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料科学是生物材料的科学.
- 公共卫生 公共卫生
背景情况:
- 部和膝关节关节的关节整形手术程序使用水泥,无水泥 (压) 或混合固定方法.
- 来自全球关节整形登记册和科学研究的现实数据为比较接与无接关节置换技术提供了实质性的基础.
研究的目的:
- 确定当前基于证据的建议,用于固与无固的部和膝盖植入物固定.
- 分析国际关节整形注册和元分析数据,以告知临床实践.
主要方法:
- 对八个国家的关节整形登记处数据进行比较分析 (美国,德国,澳大利亚,英国,瑞典,挪威,新西兰,荷兰).
- 评估了22项审查研究和分析,重点关注注册表数据.
- 评估各种国家的医疗保健系统建议.
主要成果:
- 在膝关节关节整形手术中使用带抗生素的骨水泥进行固固定与更长的植入物存活率和更低的修复率有关.
- 对于70岁及以上的患者来说,关节茎固定在水泥上显著降低了周围假肢骨折的风险 (降低了四倍的风险).
- 带有抗生素的骨水泥显然降低了周围假肢感染的风险,特别是在为股骨部骨折接受关节整形手术的患者中.
结论:
- 使用带有抗生素的骨水泥进行全膝关节置换是国际公认的,基于证据的标准.
- 国际注册数据和元分析支持老年患者的关节干固定.
- 基于证据的关于固关节干固定的建议需要在德国,美国和澳大利亚等国家在临床实践中得到更广泛的实施.
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