在全关节整形手术之前减肥与术后风险降低无关
Michael W Seward1, Jessica A Grimm2, Charles P Hannon1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
The Journal of bone and joint surgery. American volume
|February 26, 2025
概括
在整部关节整形手术 (THA) 之前的术前减肥并不常见,大多数患者无法实现显著的减肥. 这项研究发现,在THA之前减肥的患者手术结果或并发症率没有改善.
科学领域:
- 整形外科手术 整形外科手术
- 肥胖医学 肥胖医学
- 健康 结果 研究 研究 结果
背景情况:
- 外科医生经常使用身体质量指数 (BMI) 切断值来确定关节整形术 (THA) 的资格.
- 有限的数据存在于患者的体重减轻模式和THA之前的结果.
研究的目的:
- 在接受初级THA的患者中确定手术前减肥的患病率.
- 在THA之前确定减肥的预测因素.
- 评估手术前减肥和THA结果之间的关联.
主要方法:
- 分析了53 038个初级THA (2002-2019) 的数据.
- 专注于2463名BMI≥30kg/m2的患者,比较手术前1-24个月的体重.
- 使用后勤回归和考克斯模型来评估体重变化对结果的影响 (例如感染,修订).
主要成果:
- 只有12%的患者在THA前减掉了≥20磅;28%的BMI≥40kg/m2达到<40kg/m2 (平均1.3年).
- 在操作时间,停留时间或出院安排方面没有观察到任何显著的改善.
- 在任何减肥组中都没有减少周围假肢关节感染,并发症,修复或重新手术率.
结论:
- 在初级THA之前,显著的手术前体重减轻是罕见的.
- 手术前体重减轻与减少并发症或改善手术结果无关.
- 目前的证据质疑手术前减肥对于减少THA并发症的唯一有效性.
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