术前结肠镜对初级全膝关节整形手术修复手术风险的影响:基于人口的综合分析
Talal Al-Jabri1, Matthew J Wood2, Lauren L Nowak3
1Trauma and Orthopaedic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
The Journal of arthroplasty
|March 19, 2025
概括
在全膝关节整形术 (TKA) 后3个月内进行结肠镜检查显著增加了重复手术和修复手术的风险. 这一发现突出了与TKA手术前最近的结肠镜检查相关的潜在风险.
科学领域:
- 整形外科手术 整形外科手术
- 胃肠病学 胃肠病学
- 传染病流行病学 传染病流行病学
背景情况:
- 结肠镜检查结肠直肠癌常见于接受全膝关节整形手术 (TKA) 的患者.
- 以前的报道表明,结肠镜检查与通过过渡性细菌血症引起的周围假肢关节感染 (PJI) 之间存在联系.
- 术前结肠镜对TKA患者PJI风险的影响仍未得到充分研究.
研究的目的:
- 调查术前结肠镜检查与PJI导致的TKA再手术和修复风险之间的关联.
- 分析来自安大略省医疗保健数据库的数据,用于接受骨关节炎治疗的TKA患者.
主要方法:
- 在安大略省 (2003-2022) 成年TKA患者的回顾性队列研究.
- 使用链接的医疗保健数据库 (CIHI,DAD,OHIP).
- 雇佣了倾向性得分匹配,考克斯回归和生存曲线分析,以评估术前结肠镜对重新手术和修复率的影响.
主要成果:
- 在TKA发生前3个月内进行结肠镜检查与TKA重复手术 (HR: 2.20) 和TKA复查 (rTKA) (HR: 2.59) 的风险显著增加有关.
- 在TKA之前的12个月内接受结肠镜检查的患者显示,1年的rTKA率为1.0%,而没有结肠镜检查的患者为0.5% (P=0.020).
- 根据多变量逻辑回归,在12个月内进行结肠镜检查时,没有发现TKA重新操作或rTKA的显著关联.
结论:
- 在TKA前3个月内接受结肠镜检查和TKA相关的再手术和修复率增加之间存在统计学上显著的关联.
- 这表明,在最近进行结肠镜检查的患者中,TKA后并发症的风险可能会增加.
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