无症状升高的炎症标志物:在初级全膝关节整形术中是否存在感染或修改的风险?
Yasin Erdoğan1, Enejd Veizi2, Başak S Sezgin1
1Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.
The Journal of arthroplasty
|October 22, 2024
概括
无症状升高的C-反应蛋白 (CRP) 和红细胞沉积率 (ESR) 不会增加周围假肢关节感染 (PJI) 或全膝关节整形术 (TKA) 后修复的风险. 这项研究发现,这些高标志物与TKA患者的不良结果之间没有联系.
科学领域:
- 整形外科手术 整形外科手术
- 生物化学 生物化学
- 传染性疾病 传染性疾病
背景情况:
- 全膝关节整形术 (TKA) 是晚期膝关节关节炎的主要治疗方法.
- 周围假肢关节感染 (PJI) 是TKA的一个严重并发症.
- 确定PJI的风险因素对于患者的治疗结果至关重要.
研究的目的:
- 调查PJI和初级TKA患者的修复手术的风险,这些患者在手术前无症状地增加了C反应蛋白 (CRP) 和红细胞沉积率 (ESR).
主要方法:
- 包括1528名在2010-2022年期间接受初级TKA的患者,包括完整的手术前生化数据和>=12个月的随访.
- 患有CRP和ESR升高的患者接受了医疗评估,以排除感染;残留升高被归类为无症状.
- 排除标准包括在第一年内死亡,炎症性关节炎,自身免疫性疾病,脏病理或败血性关节炎.
主要成果:
- 一年内修订率为1.6%,五年内修订率为3.8%.
- 周围假肢关节感染 (PJI) 率在第一年为1.7%,在第五年为2.9%.
- 在研究变量中,回归分析没有发现修订或PJI的显著风险因素.
结论:
- 无症状升高的急性相反应剂 (CRP和ESR) 与TKA后PJI或无菌修订的风险增加无关.
- 平均随访6.4年的整体存活率为96.7%,其中PJI占2.2%的修订.
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