在全膝关节关节整形术后的神经瘤和持续的术后疼痛
Rachana Suresh1, Anirudh Buddhiraju2, Visakha Suresh1
1From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Annals of plastic surgery
|July 2, 2025
概括
在全膝关节整形术 (TKA) 后持续的膝盖疼痛影响25%的患者. 神经瘤是被诊断不足的原因,只有5%被诊断出来,这凸显了在TKA疼痛管理中需要更高的怀疑.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 神经学 神经学
背景情况:
- 术后持续的膝盖疼痛是全膝关节整形术 (TKA) 后的常见并发症.
- 这种疼痛可能是多因素的,而外围神经瘤是一个未被认可的原因.
- 神经瘤,或神经损伤,可以来自神经化膝关节,带或覆盖皮肤.
研究的目的:
- 为了确定外围神经瘤的发病率和结果,在TKA后经历持续膝盖疼痛的患者中.
- 为了比较TKA患者和没有神经瘤诊断的患者之间的修复手术率.
- 评估TKA患者神经瘤的干预措施.
主要方法:
- 来自TriNetX研究网络 (2016-2024) 的446,969名初级TKA患者的回顾性分析.
- 确定患有持续膝盖疼痛 (>3个月) 的患者,不包括急性或与植入物相关的原因.
- 组间的神经瘤诊断率,修订率和干预利用率的比较.
主要成果:
- 25%的TKA患者 (111,533/446,969) 经历了持续的膝盖疼痛.
- 在那些持续疼痛的人中,5.2% (5,785) 被诊断为神经瘤,通常在TKA后几年才被诊断出来.
- 神经瘤和非神经瘤组的修订率相似 (0.5%),但10.5%的神经瘤患者接受了干预.
结论:
- 很大一部分TKA患者患有持续性疼痛,神经瘤可能是被诊断不足的病因.
- 诊断的神经瘤的发病率很低 (5.2%),这表明需要增加临床怀疑.
- 标准的TKA切口带有神经损伤的风险,需要考虑耐火性膝关节疼痛中的神经瘤.
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