致病性肥胖患者的主要膝盖整体固定方法:水泥,干和无水泥的设计
Tobenna N Nwankwo1, Nicholas R Olson1, Brandon M Crowley2
1Anderson Orthopaedic Research Institute, Alexandria, Virginia.
The Journal of arthroplasty
|September 17, 2025
概括
对于接受全膝关节整形手术 (TKA) 的致病肥胖患者,所有腿固定方法都显示出良好的生存率和低无菌松动. 混凝土茎具有最低的无菌松动率,而无混凝土的设计显示出有希望的早期生存.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 临床结果研究研究
背景情况:
- 患有致病性肥胖症 (BMI ≥40) 的患者在全膝关节整形术 (TKA) 中存在独特的挑战,特别是关于无菌骨松动.
- 评估不同的骨固定策略对于优化高风险人群中TKA结果至关重要.
研究的目的:
- 为了比较植入物存活率,临床结果和患者报告的结果措施 (PROMs) 在接受初级TKA的致病肥胖患者的三种部设计中.
- 评估不同腿固定方法中无菌腿松和其他修改原因的发生率.
主要方法:
- 对1,359名BMI≥40的患者进行了回顾性队列研究,这些患者接受了初级TKA (2010-2024).
- 患者被分为三组:有茎的骨,没有茎的骨和没有骨.
- 主要结局:植入物存活率. 二次结果:修订率,并发症,PROMs,运动范围和足角.
主要成果:
- 无水泥的骨设计在一年,两年和五年内表现出最高的生存率,尽管在统计学上并不显著.
- 没有发生无菌骨松动的骨有茎的水泥骨;在没有茎的水泥骨 (0.38%) 和无水泥骨 (0.36%) 中观察到较低的比例.
- 所有的PROM在所有组中都在术后得到改善,没有显著的组间差异.
结论:
- 所有三种部件设计 (用茎结,没有茎结,无结) 在患有病态肥胖的TKA患者中都显示出高生存率和低无菌部松动率.
- 混凝土茎显示无菌松动的发病率最低,而无混凝土的设计表明有希望的早期生存.
- 植入物选择应该是个性化的,考虑患者因素和外科医生的偏好,因为所有固定方法似乎都是可行的.
更多相关视频
05:34A Mini-Invasive Internal Fixation Technique for Studying Immobilization-Induced Knee Flexion Contracture in Rats
Published on: May 20, 2019
8.3K
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
923
相关概念视频
Disorder of Water Balance
2.1K
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
2.1K
Moisture Content and Bulking of Aggregate
691
The moisture content of aggregates is a crucial factor in construction, particularly in concrete mixing, as it influences the total water required in the mix. Moisture content represents the water coated on the exterior surface of the aggregate existing in a saturated and surface-dry condition. The total water content of a moist aggregate is the sum of its moisture content and water absorption.
When aggregates are exposed to rain or sit in stockpiles, they absorb moisture, which must be...
When aggregates are exposed to rain or sit in stockpiles, they absorb moisture, which must be...
691
Curing of Concrete
1.4K
The hydration of cement takes place within the water-filled capillary pores. However, environmental elements can disrupt this process by evaporating water from the concrete surfaces. Sealed concrete with a water-cement ratio below 0.5 experiences self-desiccation, leading to water loss. The water loss in concrete is mitigated by curing. This technique involves keeping the concrete saturated to maintain the necessary temperature and moisture conditions, to optimally fill the spaces in the cement...
1.4K
Curing Methods
411
Concrete members with a small surface-to-volume ratio are cured by oiling and moistening the forms before casting the concrete member. These forms can be left in place for a prolonged period to prevent moisture loss, and can be wetted if made of a material suitable for wetting. If the forms are removed early, the concrete member is moistened and covered with polythene sheets to maintain moisture. For large horizontal concrete surfaces exposed to dry weather, a temporary covering is suspended...
411
Design Example: Joints in Concrete Pavements
774
Concrete pavement joints are essential for maintaining the structural integrity and longevity of pavement by controlling where and how the pavement cracks. These joints can be categorized based on their functions, such as contraction or control joints, construction joints, isolation joints, and expansion joints.
Contraction joints are typically formed by sawing a groove into the concrete shortly after it has hardened. This creates a weakened vertical plane, deliberately encouraging cracking at...
Contraction joints are typically formed by sawing a groove into the concrete shortly after it has hardened. This creates a weakened vertical plane, deliberately encouraging cracking at...
774
Design Example: Managing Concrete Workability
410
This example deals with managing the workability of concrete for a raft foundation project under hot weather conditions. Workability is crucial for ensuring the concrete is easy to place, compact, and finish. In this scenario, a slump test — a common method to measure the workability of fresh concrete — initially indicated low workability. This was attributed to the rapid water loss from the concrete mix, exacerbated by the high temperatures causing the course aggregates to heat up.
410
