糖尿病神经病变是膝盖关节整形术后不良整形结果的强有力的危险因素
Travis Kotzur1, Morgan Barnes1, Blaire Peterson1
1UT Health San Antonio, Department of Orthopaedic Surgery, San Antonio, Texas.
The Journal of arthroplasty
|November 16, 2025
概括
糖尿病外围神经病变 (DPN) 在全膝关节整形术 (TKA) 后显著增加了关节感染,骨折和修复手术的风险. 与接受TKA的糖尿病人和非糖尿病人相比,DPN患者面临的并发症率更高.
科学领域:
- 整形外科手术 整形外科手术
- 糖尿病学 糖尿病学
- 神经学 神经学
背景情况:
- 糖尿病外围神经病变 (DPN) 是糖尿病的一个常见并发症.
- 在全膝关节整形术 (TKA) 后DPN对结局的影响仍然不完全理解,特别是与没有神经病变的糖尿病患者相比.
研究的目的:
- 研究糖尿病外围神经病变 (DPN) 对全膝关节整形术 (TKA) 结果的影响.
- 为了比较DPN患者的TKA结局与非糖尿病患者和没有神经病变的糖尿病患者.
主要方法:
- 使用全球临床研究网络 (2005-2022) 的回顾性队列研究.
- 通过ICD-10和CPT代码识别的接受TKA的患者,根据糖尿病和DPN状态分层.
- 倾向性得分匹配 (1:1) 和后勤回归用于评估2年的骨科和90天的医疗/医院并发症.
主要成果:
- 包括318,851名TKA患者:227,597名非糖尿病患者,68,694名没有DPN的糖尿病患者,22,560名患有DPN.
- 与没有神经病变的糖尿病患者相比,DPN患者在2年内出现关节感染 (RR1.69),周围假肢骨折 (RR1.64) 和修复手术 (RR 1.49) 的风险较高.
- 与非糖尿病患者相比,DPN患者的两年骨科并发症风险也显著增加.
结论:
- 糖尿病外围神经病变显著增加了TKA后医疗和手术并发症的几率.
- DPN独立地与TKA后关节感染,周围假肢骨折和修复手术的风险更高有关.
- 整形外科医生必须考虑DPN带来的手术风险增加,而不仅仅是糖尿病的一般影响.
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