Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
J Arthroplasty. 2013 Sep;28(8 Suppl):92-5. doi: 10.1016/j.arth.2013.07.005. Epub 2013 Aug 9.
Between 2000 and 2009, demographics, clinical characteristics, and infection details were compared among patients undergoing simultaneous BTKA (SBTKA), staged or UTKA. 2825 (16%) patients underwent SB, 1151 (6%) staged, and 13,983 (78%) UTKA. The overall infection rate following SBTKA (0.57%) was lower compared to staged (1.39%) or UTKA (1.1%) (P=0.01). The in-hospital infection rate was lower for the SB group (0.28% vs. 0.96% vs. 0.69%, respectively, P=0.01). The rate of late infections was comparable between the groups (0.32% vs. 0.43% vs. 0.43%, respectively, P=0.72). The rate of superficial infection was lower in the simultaneous cohort (0.28% vs. 1.04% vs. 0.87%; P=0.003). The overall rate of deep infection and reoperation for infection was similar among the groups. Among patients with late infection, age, gender, comorbidity score, time to infection, and most common organism isolated were not significantly different between the groups. Among infected patients after SB or staged TKA, 3 SB patients (18.75%), and 3 staged (20%) had bilateral involvement (P=1.0). Staged patients had more 2nd side infections, while simultaneous patients had more 1st side infections (P=0.02). Regression analysis showed that UTKA patients were 2.5 times more likely to develop in-hospital infection compared to SBTKA, while staged patients were almost 3.4 times more likely. Each additional hospital day increased the risk of late infection by 11.3%. SBTKA demonstrates an advantage over staged and maintains the safety profile of unilateral approaches with respect to infectious complications.
在 2000 年至 2009 年期间，对同时行双侧全膝关节置换术（SBTKA）、分期或单侧全膝关节置换术（UTKA）的患者进行了人口统计学、临床特征和感染细节的比较。2825 例（16%）患者接受了 SB，1151 例（6%）分期，13983 例（78%）UTKA。与分期（1.39%）或 UTKA（1.1%）相比，SBTKA 后总体感染率（0.57%）较低（P=0.01）。SB 组的院内感染率较低（0.28%比 0.96%比 0.69%，P=0.01）。各组之间晚期感染率相当（0.32%比 0.43%比 0.43%，P=0.72）。浅表感染率在同期队列中较低（0.28%比 1.04%比 0.87%；P=0.003）。各组之间深部感染和因感染而再次手术的总发生率相似。在晚期感染患者中，各组之间的年龄、性别、合并症评分、感染时间和最常见的分离菌均无显著差异。在接受 SB 或分期 TKA 治疗后发生感染的患者中，3 例 SB 患者（18.75%）和 3 例分期患者（20%）存在双侧感染（P=1.0）。分期患者有更多的第 2 侧感染，而同期患者有更多的第 1 侧感染（P=0.02）。回归分析显示，与 SBTKA 相比，UTKA 患者发生院内感染的可能性增加了 2.5 倍，而分期患者则增加了近 3.4 倍。每增加 1 天住院时间，晚期感染的风险增加 11.3%。SBTKA 与分期相比具有优势，并且在感染并发症方面保持了单侧方法的安全性。
