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恶性病与关节整形术有关吗? 一个元分析.

Thomas Johnstone^1,2, Jamasb J Sayadi³, Jagmeet S Arora⁴

¹Stanford University School of Medicine, Stanford University, Stanford, CA, USA.

Clinical orthopaedics and related research

|August 19, 2025

概括

整体关节整形术 (THA/TKA) 不会增加癌症的风险. 这次元分析没有发现关节或膝关节置换与恶性瘤之间的联系,无论植入物类型或随访持续时间如何.

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科学领域:

整形外科手术整形外科手术
在瘤学瘤学.
流行病学流行病学

背景情况:

骨科植入物和癌症之间的潜在联系尚不清楚,尽管在其他医疗环境中存在关联.
现有关于全关节整形术 (THA/TKA) 和癌症风险的研究已经产生了不一致的结果.
需要进行全面的元分析,以澄清THA/TKA与恶性瘤风险之间的关系.

研究的目的:

为了确定THA或TKA是否与癌症风险增加有关.
调查特定的植入物类型 (例如,金属对金属,水泥) 是否与更高的癌症风险相关.
评估随访时间是否会影响关节塑形术后观察到的癌症风险估计.

主要方法:

来自PubMed,Embase和SCOPUS的研究的系统审查和元分析.
包括16项高质量的研究 (纽卡斯尔-太华尺度6-8),涉及977465名患者和超过740万人年.
用于汇集数据的随机效应模型,对植入物类型和随访持续时间进行子组分析.

主要成果:

与一般人群相比,在接受THA或TKA的患者中没有观察到癌症风险增加 (REE = 0.99,p=0.88).
亚组分析显示,TKA (REE=1.02),THA (REE=0.99),水泥植入物 (REE=1.00) 或金属对金属植入物 (REE=1.02) 的癌症风险没有增加.
根据随访时间 (<10年:REE=0.93;≥10年:REE=1.05),癌症发病率没有差异,随访时间和癌症风险之间没有发现关联 (p=0.66).

结论:

目前的证据支持推关节整形手术,而不增加与癌症相关的担忧.
未来的研究应该专注于更长的随访期和详细的患者/植入物数据.
需要在大型链接研究中改善全球代表性,以表征罕见或长期潜伏的恶性瘤.