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单髁膝关节置换术后的死亡率及围手术期并发症

Mortality and perioperative complications after unicompartmental knee arthroplasty.

作者信息

Morris Michael J, Molli Ryan G, Berend Keith R, Lombardi Adolph V

机构信息

Joint Implant Surgeons, Inc., 7277 Smith's Mill Road, Suite 200, New Albany, OH 43054, USA.

出版信息

Knee. 2013 Jun;20(3):218-20. doi: 10.1016/j.knee.2012.10.019. Epub 2012 Nov 14.

Abstract

AIM OF STUDY

Unicompartmental knee arthroplasty (UKA) has been increasingly utilized over the past decade secondary to favorable reports of better range of motion, higher activity levels, and increased patient satisfaction compared with total knee arthroplasty (TKA). The aim of this study was to determine the 90-day incidence of perioperative complications and mortality of patients undergoing UKA.

METHODS

One thousand consecutive UKA in 828 patients were retrospectively reviewed. A retrospective review was performed to evaluate 90-day perioperative complication and mortality rates.

RESULTS

There were zero deaths during the study period. Twelve percent of surgeries were complicated by variances within the 90-day postoperative period. There was one deep venous thrombosis (0.1%) and no pulmonary emboli. Cardiovascular complications were infrequent. Three patients had a myocardial infarction (0.31%), one developed congestive heart failure (0.1%), one angina (0.1%), and three had arrhythmias (0.31%). Secondary procedures were performed in 15 patients during the follow-up period: seven were manipulations under anesthesia for arthrofibrosis, one was an arthroscopic removal of retained cement, one arthroscopic removal of a drain, one repeat wound closure after a dehiscence secondary to a fall, one open reduction internal fixation for a supracondylar femur fracture, three irrigation and debridement procedures for an aseptic hematoma, and one radical debridement with later successful conversion to a total knee arthroplasty for a periprosthetic infection.

CONCLUSION

This study supports the notion that UKA is a safe procedure that is associated with a low rate of mortality and serious post-operative complications.

摘要

研究目的

在过去十年中,单髁膝关节置换术(UKA)的使用越来越多,这是因为与全膝关节置换术(TKA)相比,它在活动范围、活动水平和患者满意度方面有更好的报道。本研究的目的是确定接受UKA的患者围手术期并发症和死亡率的90天发生率。

方法

回顾性分析了828例患者连续进行的1000例UKA手术。进行回顾性分析以评估90天围手术期并发症和死亡率。

结果

研究期间无死亡病例。12%的手术在术后90天内出现并发症。有1例深静脉血栓形成(0.1%),无肺栓塞。心血管并发症少见。3例发生心肌梗死(0.31%),1例发生充血性心力衰竭(0.1%),1例发生心绞痛(0.1%),3例发生心律失常(0.31%)。随访期间15例患者进行了二次手术:7例因关节纤维性变在麻醉下进行手法操作,1例关节镜下取出残留骨水泥,1例关节镜下取出引流管,1例跌倒后伤口裂开再次缝合,1例股骨髁上骨折切开复位内固定,3例无菌性血肿进行冲洗和清创,1例进行根治性清创,随后成功转换为全膝关节置换术治疗假体周围感染。

结论

本研究支持UKA是一种安全的手术,死亡率和严重术后并发症发生率较低的观点。

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