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在接受全膝关节关节整形手术的患者中,有或没有先前的膝关节硬件,类似的PROM和医疗保健利用
Khaled A Elmenawi1, Nickelas Huffman1,
1Department of Orthopedic Surgery, Orthopedic and Rheumatology Institute Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH A4144195 USA.
Indian journal of orthopaedics
|February 11, 2026
概括
膝关节整形术 (TKA) 在患有先前膝关节硬件的患者中显示出与没有硬件的患者相似的结果. 这项研究没有发现患者报告的结果,医疗保健使用或一年后的生存率有显著差异.
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:
- 膝关节整形术 (TKA) 在患有先前膝关节硬件的患者中提出了独特的外科手术挑战.
- 关于患者报告的结果指标 (PROM) 和这一特定人群的医疗保健利用情况的数据有限.
- 之前的硬件可能会影响TKA后的并发症风险和功能恢复.
研究的目的:
- 为了比较1年的PROM,医疗保健利用率和在患者中进行的TKAs之间的生存率,在患者中进行了先前的膝盖硬件 (板/螺丝或骨髓内指甲) 和没有硬件的对照组.
- 评估先前的膝盖硬件是否会影响临床上显著的疼痛改善,关节置换功能和身体功能.
- 评估停留时间,再入院,急诊,出院安排和需要修复手术的差异.
主要方法:
- 一项回顾性研究将51个TKA与先前的膝关节硬件 (36个板/螺丝,15个骨髓内钉) 匹配到2016-2023年的102个对照.
- 包括膝关节损伤骨关节炎结局分数 (KOOS) 的疼痛,关节置换 (JR) 和身体功能缩短 (PS) 的PROMs被评估为最小临床重要差异 (MCID) 和患者可接受的症状状态 (PASS).
- 医疗保健利用指标 (LOS,再入院,急救访问,DD,干部使用) 和生存率 (死亡率,重新手术) 在1年内进行了比较.
主要成果:
- 两组之间在1年KOOS-疼痛,PS或JR得分上没有发现显著差异.
- 在所有组中,实现MCID和PASS值的比率都相似.
- 在LOS,90天再入院,急救诊所访问,出院处置,茎使用,死亡率和重新手术率中发现了微不足道的差异.
结论:
- 膝关节关节整形手术在患有膝关节硬件的患者中,产生的1年PROM,医疗保健利用率和生存率与没有先前硬件的患者相比相当.
- 这些发现表明,先前的膝关节硬件不会对TKA后的短期结果产生不利影响.
- 对管理策略的进一步研究对于优化这种复杂患者队列的结果至关重要.
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