骨骼发育不良患者下肢全关节成形术的疗效:系统性综述

IF 1.5 Q3 ORTHOPEDICS Arthroplasty Today Pub Date : 2024-08-09 DOI:10.1016/j.artd.2024.101405
Paul Guirguis BA, Lucas Fowler MD, Benjamin F. Ricciardi MD
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引用次数: 0

摘要

背景遗传性骨骼发育不良患者往往因早期关节退变而需要进行下肢全关节成形术(TJA);然而,有关该人群全关节成形术效果的数据却很少。我们的目的是回顾文献,以确定遗传性骨骼发育不良患者的全膝关节置换术和全髋关节置换术(THA)的并发症发生率、翻修率、植入物存活率和患者报告的结果。方法对在线数据库(PubM 和 Google 学术)中有关遗传性骨骼发育不良患者的 THA 或全膝关节置换术结果的研究进行了系统性的文献综述。病例报告和仅根据身高定义发育不良的研究被排除在外。14项研究符合数据提取和分析的标准。结果我们的研究共纳入了596名骨骼发育不良患者,中位随访时间为6.01年(1.7-15.9年)。平均年龄为 54.04 岁,平均体重指数为 29.1 kg/m2。65.7%的 THAs 采用无骨水泥固定,而所有膝关节均采用骨水泥固定。髋关节植入物10年存活率为79%,20年存活率为56%。膝关节假体10年存活率为92%,20年存活率为46%。髋关节和膝关节的翻修率分别为15.3%和13.5%。最常见的适应症是无菌性松动和聚乙烯磨损。结论有关遗传性骨骼发育不良患者下肢TJA的文献显示,10年植入存活率适当,所有调查领域的患者报告结果均有所改善。
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Outcomes of Lower Extremity Total Joint Arthroplasty in Patients With Skeletal Dysplasia: A Systematic Review

Background

Patients with genetic skeletal dysplasias often require lower extremity total joint arthroplasty (TJA) due to early joint degeneration; however, little data exists regarding the outcomes of TJA in this population. Our purpose was to review the literature to determine the complication rates, revision rates, implant survivorship, and patient-reported outcomes of total knee arthroplasty and total hip arthroplasty (THA) in those with genetic skeletal dysplasias.

Methods

A systematic literature review of online databases (PubMed and Google Scholar) was conducted. Studies that reported the outcomes of THA or total knee arthroplasty in patients with genetically confirmed skeletal dysplasias were included. Case reports and studies that defined dysplasia based on height alone were excluded. Fourteen studies met the criteria for data extraction and analysis.

Results

Our review yielded a sample of 596 skeletal dysplasia patients with a median follow-up of 6.01 years (1.7-15.9). Mean age was 54.04 years, and mean body mass index was 29.1 kg/m2. Cementless fixation was utilized in 65.7% of THAs, while all knees were cemented. Hip implant survivorship was 79% at 10 years and 56% at 20 years. Knee implant survivorship was 92% at 10 years and 46% at 20 years. Hip and knee revisions were 15.3% and 13.5%, respectively. The most common indication was aseptic loosening and polyethylene wear. Patient-reported outcomes improved across all domains.

Conclusions

The literature regarding lower extremity TJA in those with genetic skeletal dysplasias demonstrates appropriate 10-year implant survivorship and improvement in patient-reported outcomes across all survey domains.

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来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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