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在风湿性关节炎患者的全关节整形术后的并发症率和功能结果

Colleen M Wixted¹, Albert T Anastasio², Billy I Kim¹

¹Duke University School of Medicine, Durham, North Carolina.

The Journal of bone and joint surgery. American volume

|April 25, 2025

概括

经过全关节整形术 (TAA) 的类风湿性关节炎 (RA) 患者报告了更糟糕的结果,但仍然显示出改善. 这项研究比较了接受TAA的RA,骨关节炎 (OA) 和创伤后关节炎患者.

科学领域:

整形外科手术整形外科手术
类风湿病学类风湿病学
生物统计学生物统计学

背景情况:

关于经过全关节整形手术 (TAA) 的类风湿性关节炎 (RA) 患者,与骨关节炎 (OA) 和创伤后关节炎 (PTA) 患者相比,存在相互矛盾的数据.
并发症和患者报告的结果 (PRO) 需要进一步进行比较分析.

研究的目的:

在接受TAA的RA,初级OA或PTA患者中比较并发症率和PROs.
评估这些患者群体的功能结果和植入物存活率.

主要方法:

从2000年3月到2020年10月,对1071个初级TAA (OA: n=372,PTA: n=642,RA: n=57) 的回顾性研究.
最少2年的随访,比较人口统计,并发症和PROs,使用不变统计和植入失败的Cox回归.
包括短期肌肉骨功能评估 (SMFA),SF-36和脚部和脚结局得分 (FAOS).

主要成果:

与OA和PTA组相比,RA队列的平均年龄较低,男性较少,ASA得分较高.
感染率没有显著差异;RA队列显示异型骨化率较高 (3.5%).
RA 队列报告了较差的术后 PRO (SMFA,SF-36,FAOS),但与基线相比显著改善;植入物失败的风险没有增加.

结论:

在最大的单一机构研究中,接受TAA的RA患者在OA和PTA组相比报告了较差的PRO得分.
尽管得分较差,但RA患者在TAA后的手术前基线相比,功能性结局有所改善.

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