55 岁或以上接受膝关节周围截骨术的患者深静脉血栓形成率较高，但术后早期并发症的总体发生率并不高。

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-09-23 DOI:10.1002/jeo2.70023

Rodrigo Olivieri, José Laso, Tomás Pineda, Pablo Albornoz, Nicolás Starocelsky, Nicolás Franulic, Jaime Ugarte

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引用次数: 0

摘要

目的：膝关节周围截骨术已被确定为治疗中青年患者与其他膝关节病变相关的膝关节屈曲或外翻错位的有效方法。有关患者年龄的风险和并发症的文献有限。本研究旨在确定年龄是否会影响膝关节周围截骨术患者术中和术后早期并发症的发生：研究对象为18岁以上接受股骨远端截骨术（DFO）或胫骨高位截骨术（HTO）的连续患者，随访时间至少90天。研究人员对这些患者的人口统计学特征、手术技术、术中和术后 90 天内的并发症进行了鉴定。根据年龄小于 55 岁或 55 岁及以上进行了统计比较，以确定患者年龄是否是并发症发生的风险因素：共纳入 159 例截骨手术，其中 129 例为 HTO。平均年龄为 46.16 岁，118 名患者小于 55 岁。7例铰链骨折是唯一的术中并发症，而术后早期并发症总发生率为11.32%。最常见的是深静脉血栓（DVT），占 5.66%，其次是深部感染，总感染率为 2.52%。在按年龄进行亚组分析时，我们发现 55 岁及以上年龄组的深静脉血栓形成率明显更高（P 0.036）（几率比 3.96 95% 置信区间 1.009-15.533; P 0.048）；然而，根据患者年龄组的不同，总体并发症发生率并无明显差异：本研究显示，在接受膝关节周围截骨术的患者中，最常见的术后并发症是深静脉血栓。55岁及以上患者的深静脉血栓发生率明显较高，但根据患者的年龄段，总体并发症发生率并无差异：证据等级：三级（回顾性队列研究）。

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Patients aged 55 or older undergoing around the knee osteotomy have a higher rate of deep vein thrombosis but not overall early post-operative complications

Purpose

Osteotomies around the knee have been established as an effective method for treating varus or valgus malalignment associated with other knee pathologies in young and middle-aged patients. There is limited literature regarding the risks and complications based on patient age. The purpose of this study is to determine whether age influences as a risk factor for developing intraoperative and early post-operative complications in patients undergoing osteotomies around the knee.

Methods

A consecutive series of patients over 18 years old who underwent distal femoral osteotomy (DFO) or high tibial osteotomy (HTO) with a minimum follow-up period of 90 days were included. Demographic characteristics, surgical technique, intraoperative and post-operative complications up to 90 days were identified. A statistical comparison based on age younger than 55 years or 55 years and older was conducted to determine if patient age acted as a risk factor in the development of complications.

Results

A total of 159 osteotomies were included, of which 129 were HTOs. The average age was 46.16 years, and 118 patients were younger than 55 years. Seven hinge fractures were identified as the only intraoperative complication, while the overall early post-operative complication rate was 11.32%. The most frequent was deep venous thrombosis (DVT) in 5.66% of cases, followed by deep infection with a total rate of 2.52%. When performing the subgroup analysis by age, we observed a significantly higher rate of DVT in the group aged 55 years and older (p 0.036) (odds ratio 3.96 95% confidence interval 1.009–15.533; p 0.048); however, no significant differences were observed in the overall complication rate according to the age group of the patients.

Conclusions

This study reveals that in patients undergoing osteotomies around the knee, the most common post-operative complication was DVT. The rate of DVT was significantly higher in patients aged 55 years and older, although no differences were observed in the overall complication rate according to the patients' age range.