双边与单边全膝关节整形:安全性和功能性结果的系统审查和元分析
Hussayn Shinwari1, Hanan Taimur Shinwari2, Zakariya Mouyer3
1Faculty of Medicine, St George's University of London, United Kingdom.
The Journal of arthroplasty
|February 11, 2026
概括
同时双边全膝关节整形术 (SBTKA) 导致住院时间更长,并发症比单边TKA (UTKA) 更多. 然而,SBTKA和UTKA患者的功能结果和生活质量是相似的.
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
- 康复医学 康复医学 康复医学
背景情况:
- 全膝关节整形术 (TKA) 是治疗晚期膝关节关节炎的标准手术.
- 同时双边TKA (SBTKA) 与单边TKA (UTKA) 的相对安全性和功能结果需要进一步研究.
- 本综述检查了SBTKA和UTKA后的并发症率,运动范围 (ROM),功能恢复和与健康有关的生活质量 (HRQoL).
研究的目的:
- 系统地审查和比较SBTKA与UTKA的安全性和功能结果.
- 评估并发症率,死亡率,再入院,停留时间 (LOS),ROM和患者报告的结果措施.
- 综合现有文献中的证据,为临床决策提供信息.
主要方法:
- 一项全面的文献搜索确定了52项涉及5,859,125名接受SBTKA或UTKA的患者的研究.
- 结果包括并发症,死亡率,再入院率 (入院至90天),LOS,ROM,膝盖协会得分 (KSS),牛津膝盖得分 (OKS),WOMAC和HRQoL.
- 分析使用随机效应模型,计算二分和连续结果的风险比率 (RR) 和平均差异 (MD).
主要成果:
- 与UTKA相比,SBTKA与较长的LOS (平均0.8天) 和更高的并发症率 (RR 1.42) 相关.
- 死亡率 (RR 1.12) 和再接收率 (RR 1.13) 在各组之间相似.
- 功能性结果 (ROM,KSS,OKS) 和HRQoL得分是可比的,SBTKA的KSS具有潜在的长期益处.
结论:
- 与UTKA相比,SBTKA增加了并发症的风险,并延长了LOS.
- 尽管风险增加,但SBTKA和UTKA之间的功能结果,ROM和HRQoL似乎可以比较.
- 需要进一步进行高质量的研究,以阐明长期结果,并优化SBTKA的患者选择.
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