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肥胖患者症状性膝关节骨关节炎的管理:骨科医生观点与实践的调查

Management of symptomatic knee osteoarthritis in obesity: a survey of orthopaedic surgeons' opinions and practice.

作者信息

Hill Daniel S, Freudmann Matthew, Sergeant Jamie C, Board Tim

机构信息

Wrightington Lower Limb Unit, Wrightington Hospital, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.

Department of Orthopaedic Surgery, Furness General Hospital, Barrow in Furness, Cumbria, LA14 1GP, UK.

出版信息

Eur J Orthop Surg Traumatol. 2018 Jul;28(5):967-974. doi: 10.1007/s00590-017-2103-9. Epub 2017 Dec 28.

Abstract

INTRODUCTION

The aim of this survey was to explore knee surgeons' opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity.

METHODS

Questionnaires were sent electronically to all consultant members of the British Association for Surgery of the Knee.

RESULTS

The response rate was 52%. The survey showed considerable practice variation and divided opinion on the evidence base. The majority stated that weight loss should be the first-line treatment. 53% (91/172) stated that such cases should ideally be assessed by a specialist multidisciplinary service; however, only 24% (41/169) would be interested in being the orthopaedic surgeon in such a service.

DISCUSSION

The optimal pathway of care for the obese patient with symptomatic knee osteoarthritis remains unclear. Given recent debate around the rationing of knee arthroplasty surgery in obesity, we felt it was timely to survey knee surgeons' current practice.

CONCLUSION

Our survey has shown considerable variation in the opinions and practice of surgeons on the management of symptomatic knee osteoarthritis in obesity, together with divided views on current literature.

摘要

引言

本次调查旨在探讨膝关节外科医生对于肥胖患者症状性膝关节骨关节炎治疗的观点和实践。

方法

通过电子邮件向英国膝关节外科协会的所有顾问成员发送问卷。

结果

回复率为52%。调查显示在实践方面存在很大差异,且对证据基础存在不同意见。大多数人表示减肥应作为一线治疗方法。53%(91/172)的人表示此类病例理想情况下应由专科多学科服务团队进行评估;然而,只有24%(41/169)的人有兴趣成为此类服务中的骨科医生。

讨论

肥胖的症状性膝关节骨关节炎患者的最佳护理途径仍不明确。鉴于近期围绕肥胖患者膝关节置换手术配给的争论,我们认为对膝关节外科医生的当前实践进行调查是及时的。

结论

我们的调查表明,外科医生对于肥胖患者症状性膝关节骨关节炎治疗的观点和实践存在很大差异,同时对当前文献也存在不同看法。

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