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我们应该等待骨关节炎吗? 在初级全关节整形手术之前需要高级成像的患者的同等临床结果

Colin C Neitzke¹, Scott M LaValva¹, Sonia K Chandi¹

¹Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York.

The Journal of arthroplasty

|May 22, 2024

概括

严重骨关节炎 (OA) 患者和不太严重的OA患者的关节整形术 (THA) 结果相似. 先进的成像可以帮助选择患者THA当严重的症状存在,但X射线图显示不太先进的OA.

科学领域:

整形外科手术整形外科手术
放射学放射学是一门学科.
类风湿病学类风湿病学

背景情况:

平面射线图是诊断骨关节炎 (OA) 的标准,指导晚期病例的全关节整形术 (THA).
先进的成像可以补充放射图片,以评估患有进展性症状但放射性发现不那么先进的患者的OA严重程度.
这项研究基于放射性发现,比较了晚期OA和不太严重OA患者的THA结果.

研究的目的:

为了比较晚期OA (Kellgren-Lawrence等级4) 患者的THA后的结果与那些不太严重的OA (Kellgren-Lawrence等级0-2) 患者的结果,正如普通放射图所显示的那样.

主要方法:

确定了一组93名Kellgren-Lawrence (KL) 级0-2级OA患者的队列,他们在2016年2月至2020年2月期间接受了THA.
根据年龄,性别,BMI和查尔森并发症指数,患者与KL 4 OA患者进行了1:3匹配.
主要结局是实现关节置换关节损伤和骨关节炎结局得分 (HOOS JR) 最小临床重要差异,实质性的临床益处和患者可接受的症状状态在1年后术后.

主要成果:

在KL 0-2和KL 4队列之间没有观察到显著差异,在1年内达到HOOS JR临床重要差异 (86%vs85.6%),实质性临床益处 (81.7%vs80.2%) 或患者可接受的症状状态 (89.2%vs85.6%) 中没有显著差异.
在KL 0-2队列中,与KL 4队列相比,他们的2年HOOS JR得分呈现出类似的改善 (42.5对38.6).

结论:

在初级THA之后的结局在普通X光照中,严重的OA (KL 4) 和不那么严重的OA (KL 0-2) 的患者之间是可比的.
在较不发达的放射性OA严重症状的情况下,先进的成像可以帮助治疗指导和患者选择THA.

关键词:

凯尔格伦 - 劳伦斯磁共振成像技术的使用最小临床重要的差异.患者可以接受的症状状态.显著的临床益处.整体关节整形术

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