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高龄患者的全膝关节置换术:疗效与并发症观察

Total Knee Arthroplasty in Patients of Advanced Age: A Look at Outcomes and Complications.

作者信息

Passias Peter G, Bono Olivia J, Bono James V

机构信息

Department of Orthopaedic Surgery, Tufts Affiliated Hospitals Orthopaedic Residency Program, Boston, Massachusetts.

Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts.

出版信息

J Knee Surg. 2020 Jan;33(1):1-7. doi: 10.1055/s-0038-1676067. Epub 2018 Nov 26.

Abstract

Total knee arthroplasty (TKA) is one of the most highly successful orthopaedic procedures performed in North America. It is also one of the most common procedures performed, and its incidence continues to increase. Despite this, it is the opinion of many that patients of advanced age groups are not ideal candidates to undergo such procedures secondary to the concern over higher complication rates and poorer functional outcomes. This review article attempts to analyze the current body of literature concerning TKA outcomes and to evaluate some of the issues that are more specific to this population when they undergo TKA. It is our hypothesis that the literature does not support this popular misconception, and that older patients who do not have significant medical comorbidities are good candidates to undergo primary TKA. However, certain cohorts of this population are not ideal candidates to undergo this procedure. Also, certain joint reconstructive procedures, such as simultaneous and staged bilateral TKA, are higher risk procedures in this patient cohort.

摘要

全膝关节置换术(TKA)是北美地区实施的最成功的骨科手术之一。它也是最常见的手术之一,并且其发病率持续上升。尽管如此,许多人认为高龄患者并非接受此类手术的理想人选,原因是担心并发症发生率更高以及功能预后较差。这篇综述文章试图分析当前有关TKA手术结果的文献,并评估该人群在接受TKA手术时一些更具特异性的问题。我们的假设是,文献并不支持这种普遍存在的误解,即没有严重内科合并症的老年患者是接受初次TKA手术的合适人选。然而,该人群中的某些亚组并非接受此手术的理想人选。此外,某些关节重建手术,如同期和分期双侧TKA,在该患者群体中属于高风险手术。

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