Suda Arnold J, Heilgeist Eva, Tinelli Marco, Bischel Oliver E
Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim 68167, Germany.
Department of Trauma and Orthopaedics, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, Ludwigshafen, 67071, Germany.
J Orthop Res. 2018 Mar;36(3):1035-1039. doi: 10.1002/jor.23718. Epub 2017 Sep 27.
The necessity of orthopedic implant removal is under intense discussion and even if it is performed as an elective procedure, the risk of complications is present. Aim of the study was to identify parameters responsible for an increased risk of early post-operative complications after elective aseptic orthopedic implant removal. We reviewed 1,545 cases of aseptic and elective orthopedic implant removal between 2009 and 2011. The patient́s demographic data, time and duration of operation, patient́s comorbidities, and presence of complications in the first 4 weeks after implant removal were evaluated. Patients with signs of infection at the time of the surgical procedure were excluded from this study. 579 women and 966 men who underwent elective aseptic orthopedic implant removal were identified. Mean age at implant removal was 42 years and mean duration of the surgical procedure was 37 min. In this cohort, 70 patients (4.5%) underwent elective aseptic implant removal after 6pm. 52 patients (3.37%) operated on during daytime suffered from complications post-operatively and five patients (0.3%) who were operated on during the night experienced complications. The parameters age, sex, BMI, and surgeon showed no statistically significant differences for the risk of post-operative complications. Patients' comorbidities such as diabetes seem to have influence but were not statistically significant either. Patients with revision surgery since their first operation, nocturnal surgery and longer duration of the procedure showed a statistically significant higher risk for complications, especially in the lower leg. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1035-1039, 2018.
骨科植入物取出的必要性正处于激烈讨论中,即便其作为一项择期手术进行,并发症风险依然存在。本研究的目的是确定导致择期无菌性骨科植入物取出术后早期并发症风险增加的参数。我们回顾了2009年至2011年间1545例无菌性择期骨科植入物取出病例。评估了患者的人口统计学数据、手术时间和时长、患者的合并症以及植入物取出后前4周内并发症的发生情况。手术时伴有感染迹象的患者被排除在本研究之外。共确定了579名接受择期无菌性骨科植入物取出术的女性和966名男性。植入物取出时的平均年龄为42岁,手术平均时长为37分钟。在该队列中,70名患者(4.5%)在下午6点后接受了择期无菌性植入物取出术。白天手术的52名患者(3.37%)术后出现并发症,夜间手术的5名患者(0.3%)出现并发症。年龄、性别、体重指数和外科医生等参数在术后并发症风险方面无统计学显著差异。患者的合并症如糖尿病似乎有影响,但也无统计学显著性。首次手术后进行翻修手术、夜间手术以及手术时间较长的患者出现并发症的风险在统计学上显著更高,尤其是在小腿部位。© 2017骨科研究协会。由威利期刊公司出版。《矫形外科学研究》36:1035 - 1039, 2018。