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类风湿关节炎、银屑病关节炎、强直性脊柱炎和骨关节炎患者原发性全膝关节置换术的并发症

Complications of Primary Total Knee Arthroplasty Among Patients With Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and Osteoarthritis.

作者信息

Cancienne Jourdan M, Werner Brian C, Browne James A

机构信息

From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

出版信息

J Am Acad Orthop Surg. 2016 Aug;24(8):567-74. doi: 10.5435/JAAOS-D-15-00501.

Abstract

BACKGROUND

Although several studies have reported outcomes of primary total knee arthroplasty (TKA) in patients with rheumatoid arthritis, very little has been reported on the outcomes of this procedure in patients with other inflammatory arthritides.

METHODS

This study used a national database to evaluate 90-day postoperative complication rates, readmission rates, and revision rates after TKA in patients with inflammatory arthritis. Patients with rheumatoid arthritis (n = 153,531), psoriatic arthritis (n = 7,918), and ankylosing spondylitis (n = 4,575) were compared with patients with osteoarthritis (n = 1,751,938) who underwent TKA from 2005 to 2012.

RESULTS

The rates of systemic complications, infection, revision, and 90-day readmission after TKA in patients with different types of inflammatory arthritis were significantly higher than those in control patients with osteoarthritis (P < 0.0001). No differences were found in the rates of systemic or local complications, revision, or readmission among the types of inflammatory arthritis.

CONCLUSION

Inflammatory arthritis is associated with increased rates of perioperative complications, revision, and 90-day readmission after primary TKA.

LEVEL OF EVIDENCE

Level III.

摘要

背景

尽管多项研究报告了类风湿关节炎患者初次全膝关节置换术(TKA)的结果,但关于该手术在其他炎性关节炎患者中的结果报道极少。

方法

本研究使用国家数据库评估炎性关节炎患者TKA术后90天的并发症发生率、再入院率和翻修率。将类风湿关节炎患者(n = 153,531)、银屑病关节炎患者(n = 7,918)和强直性脊柱炎患者(n = 4,575)与2005年至2012年接受TKA的骨关节炎患者(n = 1,751,938)进行比较。

结果

不同类型炎性关节炎患者TKA术后的全身并发症、感染、翻修和90天再入院率显著高于骨关节炎对照患者(P < 0.0001)。不同类型炎性关节炎之间的全身或局部并发症、翻修或再入院率未发现差异。

结论

炎性关节炎与初次TKA术后围手术期并发症、翻修和90天再入院率增加有关。

证据水平

三级。

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