无菌失败后翻修全膝关节置换术时间对预后的影响。

IF 4.1 Q1 ORTHOPEDICS Knee Surgery & Related Research Pub Date : 2023-05-30 DOI:10.1186/s43019-023-00191-5
Mackenzie A Roof, Shankar Narayanan, Nathan Lorentz, Vinay K Aggarwal, Morteza Meftah, Ran Schwarzkopf
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引用次数: 0

摘要

先前的研究已经证明翻修全膝关节置换术(rTKA)的时间与适应症之间存在关联;然而,早期和晚期翻修对术后结果的影响尚未见报道。材料和方法:一项回顾性观察性研究调查了2011年6月至2020年4月在一家学术骨科医院接受单侧无菌rTKA手术的患者,随访时间超过1年。如果患者在2年内进行原发性TKA (pTKA)翻修,则进行早期翻修;如果患者在2年后进行翻修,则进行晚期翻修。比较患者人口统计学、手术因素和术后结果。结果:共纳入rTKA 470例(早期199例,晚期271例)。早期rTKA患者年轻2.5岁(p = 0.002)。早期rTKA的主要适应症是不稳定(28.6%)和关节纤维化/僵硬(26.6%),晚期rTKA的主要适应症是无菌性松动(45.8%)和不稳定(26.2%);结论:2岁前进行的无菌rTKA有不同的适应症,但结果与之后进行的相似。早期改型手术时间较短,这可能归因于rTKA适应症的差异。证据水平:III级,回顾性观察性分析。
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Impact of time to revision total knee arthroplasty on outcomes following aseptic failure.

Introduction: Prior studies have demonstrated an association between time to revision total knee arthroplasty (rTKA) and indication; however, the impact of early versus late revision on post-operative outcomes has not been reported.

Materials and methods: A retrospective, observational study examined patients who underwent unilateral, aseptic rTKA at an academic orthopedic hospital between 6/2011 and 4/2020 with > 1-year of follow-up. Patients were early revisions if they were revised within 2 years of primary TKA (pTKA) or late revisions if revised after greater than 2 years. Patient demographics, surgical factors, and post-operative outcomes were compared.

Results: 470 rTKA were included (199 early, 271 late). Early rTKA patients were younger by 2.5 years (p = 0.002). The predominant indications for early rTKA were instability (28.6%) and arthrofibrosis/stiffness (26.6%), and the predominant indications for late rTKA were aseptic loosening (45.8%) and instability (26.2%; p < 0.001). Late rTKA had longer operative times (119.20 ± 51.94 vs. 103.93 ± 44.66 min; p < 0.001). There were no differences in rTKA type, disposition, hospital length of stay, all-cause 90-day emergency department visits and readmissions, reoperations, and number of re-revisions.

Conclusions: Aseptic rTKA performed before 2 years had different indications but demonstrated similar outcomes to those performed later. Early revisions had shorter surgical times, which could be attributed to differences in rTKA indication.

Level of evidence: III, retrospective observational analysis.

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