患有活跃癌症的患者在全关节关节整形术后有更改手术的风险增加吗? 一个倾向匹配的研究
Braden V Saba1, Olivia Schaffer1, Valentina Schiro1
1New York University Langone Orthopedic Hospital, New York, USA.
Archives of orthopaedic and trauma surgery
|November 24, 2025
概括
接受全关节整形手术 (TJA) 的活跃癌症患者表现与非癌症患者相似. 虽然与感染相关的修订在癌症患者中更频繁,但它们是可治疗的,支持TJA在特定情况下的安全性.
科学领域:
- 整形外科手术 整形外科手术
- 在瘤学瘤学.
- 临床结果研究研究
背景情况:
- 整体关节整形术 (TJA) 已经扩大了说明范围,但活跃的癌症患者仍然是一个具有挑战性的手术群体.
- 从历史上看,由于感知到高风险,活跃的癌症患者经常被排除在TJA研究之外.
研究的目的:
- 为了比较活跃癌症患者的术前和两年术后结果,与接受初级TJA的非癌症患者进行比较.
- 评估TJA在患有活跃恶性瘤的患者中的安全性和有效性.
主要方法:
- 在单个学术中心对初级单边TJA患者 (2017-2023) 的回顾性审查.
- 68名活跃癌症患者与204名非癌症患者的倾向性得分匹配 (3:1) 基于关键的人口和临床因素.
- 对人口统计,术后和临床结果的分析,包括修订率和原因,以及对癌症治疗状态的子组分析.
主要成果:
- 群体之间没有显著的人口统计差异,除了查尔森并发症指数.
- 排放处置,操作时间或停留时间没有差异.
- 在癌症患者中,所有原因的修订率较高,但在统计学上并不显著 (7.4%对2.5%);感染是癌症患者修订的更常见原因 (4.4%对0%).
结论:
- 活跃癌症患者在初级TJA后表现出可比的整体结果,挑战了传统的排除标准.
- 感染相关的修订,虽然在癌症患者中更常见,但得到了有效的管理.
- 选择的活跃癌症患者可以在适当的手术前优化和多学科护理下安全地接受TJA.
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