双侧同期与分期全膝关节置换术：并发症与死亡率的比较
Bilateral Simultaneous vs Staged Total Knee Arthroplasty: A Comparison of Complications and Mortality.
作者信息
Sheth Dhiren S, Cafri Guy, Paxton Elizabeth W, Namba Robert S
机构信息
Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, California.
Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California.
出版信息
J Arthroplasty. 2016 Sep;31(9 Suppl):212-6. doi: 10.1016/j.arth.2016.03.018. Epub 2016 Mar 17.
BACKGROUND
The purpose of this study was to compare the complications and mortality between bilateral simultaneous total knee arthroplasty (BTKA-Simultaneous) and bilateral staged TKA (BTK-Staged) while adjusting for differences in patient, surgeon, and hospital characteristics.
METHODS
An integrated health care system total joint registry was used to compare patients undergoing BTKA-Simultaneous to BTKA-Staged. For outcomes related to revision and infection, the sample included 11,118 patients, and for outcomes of death, acute myocardial infarction, stroke, and venous thromboembolism, a subsample of 7991 patients with comorbidity data was selected.
RESULTS
Overall death and complications in both groups were rare. The complication rates for BTKA-Simultaneous and BTKA-Staged were comparable: aseptic revision (1.17% vs 0.9%), septic revision/deep infection (0.8% vs 0.7%), death (0.28% vs 0.1%), and adverse events (2.49% vs 1.97%). In the adjusted models, there were no significant differences in any of the outcomes between the 2 groups.
CONCLUSION
There is a lack of evidence to support superiority of either BTKA-Simultaneous or BTKA-Staged.
背景
本研究的目的是在调整患者、外科医生和医院特征差异的同时，比较双侧同期全膝关节置换术（BTKA - 同期）和双侧分期全膝关节置换术（BTKA - 分期）的并发症和死亡率。
方法
使用综合医疗保健系统全关节登记处，比较接受BTKA - 同期和BTKA - 分期的患者。对于与翻修和感染相关的结局，样本包括11,118名患者，对于死亡、急性心肌梗死、中风和静脉血栓栓塞的结局，选择了7991名有合并症数据的患者子样本。
结果
两组的总体死亡率和并发症均很少见。BTKA - 同期和BTKA - 分期的并发症发生率相当：无菌性翻修（1.17%对0.9%）、感染性翻修/深部感染（0.8%对0.7%）、死亡（0.28%对0.1%）和不良事件（2.49%对1.97%）。在调整模型中，两组在任何结局方面均无显著差异。
结论
缺乏证据支持BTKA - 同期或BTKA - 分期的优越性。
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