在全膝关节整形术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
|August 11, 2025
概括
在肥胖患者全膝关节整形手术 (TKA) 之前的体重减轻与术后结果的改善无关. 大多数患者没有实现显著的体重减轻,体重增加与并发症有关.
科学领域:
- 整形外科手术 整形外科手术
- 肥胖药物 肥胖药物 肥胖药物
- 生物统计学 生物统计学
背景情况:
- 外科医生经常建议肥胖患者在全膝关节整形手术 (TKA) 之前减肥.
- 手术前减肥对TKA结果的影响尚不清楚.
- 这项研究旨在评估体重变化模式及其对TKA结果的影响.
研究的目的:
- 在接受TKA的肥胖患者中确定手术前减肥的患病率.
- 在这个患者群体中确定减肥的预测因素.
- 评估手术前体重变化与关键术后结果之间的关联.
主要方法:
- 对3665名接受初级TKA (2002-2019) 的肥胖患者 (BMI ≥30 kg/m2) 的回顾性分析.
- 在手术前1-24个月和手术期间测量体重变化.
- 统计模型 (逻辑回归,Cox危险) 分析了预测因素和结果 (感染,并发症,修订).
主要成果:
- 只有26%的患者减轻了≥5磅;20%的体重增加.
- 体重减轻10-20磅与修复和周围假肢关节感染 (PJI) 的风险增加有关.
- 体重增加>5磅与延长住院和并发症的可能性更高相关.
结论:
- 在肥胖的TKA患者中,显著的手术前体重减轻并不常见.
- 达到典型的减肥目标并没有改善TKA结果.
- 虽然健康体重是有益的,但TKA前的体重减轻可能不足以改善大多数肥胖患者的结果.
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