在全膝关节整形术后,麻醉下操纵失败的风险因素
Sahil Prabhnoor Sidhu1, Lisa C Howard2, Gabrielle Levesque2
1University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. sahil.p.sidhu@gmail.com.
概括
在全膝关节整形术 (TKA) 后,在麻醉下进行手术 (MUA) 可能会在BMI较高或手术前膝关节曲较差的患者中失败. 之前的膝盖手术也预测了硬度的修订.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 康复医学 康复医学 康复医学
背景情况:
- 麻醉下的操纵 (MUA) 是一种常见的程序,用于解决全膝关节整形术 (TKA) 后的硬.
- 识别MUA失败的风险因素对于优化患者的治疗结果和治疗策略至关重要.
- 之前的研究还没有全面确定TKA后MUA失败的预测因素.
研究的目的:
- 确定经过TKA的患者在MUA后失败的独立风险因素.
- 分析可能预测MUA成功或失败的临床,患者和手术变量.
主要方法:
- 一个回顾性队列研究,涉及470名接受MUA初级后TKA的患者,随访时间至少2年.
- 患者被分为成功 (n=412) 或失败 (n=58) 组,失败定义为 <90° 屈曲或对刚度的修订.
- 用单变量和多变量逻辑回归分析来确定重要的风险因素.
主要成果:
- 身体质量指数 (BMI) 在30-35 (OR 2.42) 和低MUA前曲 (OR 1.43) 之间的升高是整体MUA失败的显著风险因素.
- 具体而言,对于由于硬度而导致的修订,BMI 30-35 (OR 3.27),MUA前下部曲 (OR 1.43) 和之前的膝盖手术史 (OR 2.31) 是预测因素.
- 诸如MUA的时间,血栓预防,手术前使用阿片类药物和抑郁/焦虑等因素与失败没有显著关联.
结论:
- 较高的BMI和减少MUA前膝盖曲是TKA患者MUA衰竭的重要风险因素.
- 之前的膝盖手术史是需要修复手术的额外预测因素,因为MUA后的硬性.
- 这些发现可以帮助临床医生更好地选择患者,并管理TKA后的MUA的预期.
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