骨质疏松症可能不是无全膝关节关节整形手术的绝对禁忌
Jacquelyn J Xu1, Matthew L Magruder2, Gabriel Lama2
1Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York.
The Journal of arthroplasty
|October 17, 2024
概括
无水泥全膝关节整形术 (TKA) 是75岁以下骨质疏松症患者的安全选择,与水泥TKA相比,其并发症率和3年生存率相似. 这为更广泛的患者群体提供了无水泥TKA的支持.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料科学 生物材料科学
- 老年医学 老年医学
背景情况:
- 由于骨的保存,年轻患者对无水泥全膝关节整形术 (TKA) 的兴趣越来越大.
- 骨质疏松症的特点是骨库较差,这一直是无TKA的禁忌.
- 在75岁以下的骨质疏松患者中评估无TKA结果至关重要.
研究的目的:
- 在75岁以下的骨质疏松患者中,比较无水泥和水泥TKA之间的植入相关并发症和医疗并发症.
- 评估这两种技术的再接收率和植入物3年存活率.
- 确定无水泥TKA是否是骨质疏松患者的可行选择.
主要方法:
- 对75岁以下骨质疏松患者的初级TKA国家索赔数据库 (2010-2022) 的回顾性分析.
- 基于人口统计和并发症的无 (n=1,321) 和 (n=6,602) 队列的倾向性得分匹配.
- 多变量后勤回归和卡普兰-梅尔分析并发症,再入院和3年生存率 (P < 0.01).
主要成果:
- 在90天/2年的植入物并发症,90天的医疗并发症或90天的再入院中,无和化的TKA之间没有显著差异.
- 卡普兰-梅尔分析显示,统计学上相似的3年全因修订存活率:无水泥的97.2%,而水泥的97.6% (P = 0.472).
- 两组人的逗留时间也相似.
结论:
- 75岁以下的骨质疏松患者与无TKA相比,在无TKA中经历了同等的医疗和植入相关并发症.
- 对于75岁以下的骨质疏松患者来说,无TKA是一种可行的选择,挑战了以前的禁忌.
- 骨质的手术内评估对于选择适合无TKA的候选人至关重要.
更多相关视频
14:49Clinical Protocol of Producing Adipose Tissue-Derived Stromal Vascular Fraction for Potential Cartilage Regeneration
Published on: September 29, 2018
41.9K
09:01Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
11.7K
相关概念视频
01:29Bone Disorders
3.4K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.4K
01:31Osteoclasts in Bone Remodeling
2.8K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
2.8K