胰岛素依赖增加了病态肥胖患者全膝关节置换术后失败的风险。
Insulin Dependence Increases the Risk of Failure After Total Knee Arthroplasty in Morbidly Obese Patients.
作者信息
Watts Chad D, Houdek Matthew T, Wagner Eric R, Abdel Matthew P, Taunton Michael J
机构信息
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
出版信息
J Arthroplasty. 2016 Jan;31(1):256-9. doi: 10.1016/j.arth.2015.08.026. Epub 2015 Aug 30.
UNLABELLED
The aims of this study were to compare the outcomes between nondiabetic (n=1284), type II diabetic (n=530), and insulin-dependent type II diabetic (n=164) morbidly obese (body mass index ≥40 kg/m(2)) patients undergoing primary total knee arthroplasty at 6-year follow-up. Patients with type II diabetes mellitus (DM) had similar outcomes when compared with non-DM patients. However, patients with insulin dependence had an increased risk of reoperation (hazard ratio [HR], 1.8; P=.005), revision (HR, 2; P=.02), and periprosthetic joint infection (HR, 2.1; P=.03), as well as decreased 10-year implant survivorship (84% vs 92%; P=.01) when compared to non-DM patients. Prospective studies should further evaluate outcomes and optimization measures within this population.
LEVEL OF EVIDENCE
Level III-prognostic study.
未标注
本研究旨在比较非糖尿病（n = 1284）、II型糖尿病（n = 530）和胰岛素依赖型II型糖尿病（n = 164）的病态肥胖（体重指数≥40 kg/m²）患者在接受初次全膝关节置换术后6年随访的结果。与非糖尿病患者相比，II型糖尿病（DM）患者的结果相似。然而，与非糖尿病患者相比，胰岛素依赖型患者再次手术风险增加（风险比[HR]，1.8；P = 0.005）、翻修风险增加（HR，2；P = 0.02）、假体周围关节感染风险增加（HR，2.1；P = 0.03），且10年植入物生存率降低（84%对92%；P = 0.01）。前瞻性研究应进一步评估该人群的结果和优化措施。
证据水平
III级 - 预后研究。
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