Department of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 500 Parnassus Ave., MU320W, San Francisco, CA 94143-0728, USA.
Clin Orthop Relat Res. 2010 Jan;468(1):45-51. doi: 10.1007/s11999-009-0945-0. Epub 2009 Jun 25.
Understanding the cause of failure and type of revision total knee arthroplasty (TKA) procedures performed in the United States is essential in guiding research, implant design, and clinical decision making in TKA. We assessed the causes of failure and specific types of revision TKA procedures performed in the United States using newly implemented ICD-9-CM diagnosis and procedure codes related to revision TKA data from the Nationwide Inpatient Sample (NIS) database. Clinical, demographic, and economic data were reviewed and analyzed from 60,355 revision TKA procedures performed in the United States between October 1, 2005 and December 31, 2006. The most common causes of revision TKA were infection (25.2%) and implant loosening (16.1%), and the most common type of revision TKA procedure reported was all component revision (35.2%). Revision TKA procedures were most commonly performed in large, urban, nonteaching hospitals in Medicare patients ages 65 to 74. The average length of hospital stay (LOS) for all revision TKA procedures was 5.1 days, and the average total charges were $49,360. However, average LOS, average charges, and procedure frequencies varied considerably by census region, hospital type, and procedure performed.
Level II, economic and decision analysis. See Guidelines for Authors for a complete description of levels of evidence.
了解美国进行的全膝关节置换术（TKA）失败的原因和翻修类型对于指导 TKA 的研究、植入物设计和临床决策至关重要。我们使用与 NIS 数据库中 TKA 翻修数据相关的新实施的 ICD-9-CM 诊断和手术代码，评估了美国进行的 TKA 翻修失败的原因和特定类型。从 2005 年 10 月 1 日至 2006 年 12 月 31 日在美国进行的 60355 例 TKA 翻修手术中审查和分析了临床、人口统计学和经济数据。TKA 翻修最常见的原因是感染（25.2%）和植入物松动（16.1%），报告的最常见的 TKA 翻修类型是所有组件翻修（35.2%）。TKA 翻修手术最常在美国 65 至 74 岁 Medicare 患者的大型、城市、非教学医院进行。所有 TKA 翻修手术的平均住院时间（LOS）为 5.1 天，平均总费用为 49360 美元。然而，平均 LOS、平均费用和手术频率因人口普查区域、医院类型和手术方式而异。
二级，经济和决策分析。有关证据水平的完整描述，请参阅作者指南。
