Gu Alex, Wei Chapman, Bernstein Simone A, Nguyen Nam Tran T, Sobrio Shane A, Liu Jiabin, Sculco Peter K
Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Department of Biology, St. Bonaventure University, Allegany, New York.
J Knee Surg. 2020 Apr;33(4):387-393. doi: 10.1055/s-0039-1677820. Epub 2019 Feb 6.
Knee osteoarthritis is a common form of arthritis, often treated by total knee arthroplasty (TKA). Complications can arise after TKAs, which may necessitate revision TKAs and further treatments. However, there remains a paucity of literature regarding influence of gender on postoperative complication rates after revision TKA. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who received revision TKAs between 2007 and 2014 were identified and recorded as male or female. Univariate and multivariate analysis was used to evaluate the incidence of multiple adverse events within 30 days of revision TKA. This study included 9,914 patients who underwent revision TKA (females = 5,728 [57.8%]; males = 4 186 [42.2%]). Male patients were shown to be at greater risk for developing 7 of 17 complications compared with female patients, and female patients were shown to be at greater risk for urinary tract infection (UTI) development. Multivariate analysis showed males as an independent risk factor for four complications and females as an independent risk factor for UTI development. Male patients were more likely to develop more complications postoperatively than female patients. Although the possibility of developing complications is relatively low, orthopaedic surgeons should be aware of increased postoperative complication rates when counseling patients who undergo revision TKA.
膝关节骨关节炎是一种常见的关节炎形式，通常通过全膝关节置换术（TKA）进行治疗。TKA术后可能会出现并发症，这可能需要进行翻修TKA及进一步治疗。然而，关于性别对翻修TKA术后并发症发生率影响的文献仍然较少。我们使用美国外科医师学会国家外科质量改进计划数据库进行了一项回顾性队列研究。确定了2007年至2014年间接受翻修TKA的患者，并记录其性别为男性或女性。采用单因素和多因素分析来评估翻修TKA术后30天内多种不良事件的发生率。本研究纳入了9914例行翻修TKA的患者（女性=5728例[57.8%]；男性=4186例[42.2%]）。结果显示，与女性患者相比，男性患者发生17种并发症中的7种的风险更高，而女性患者发生尿路感染（UTI）的风险更高。多因素分析显示，男性是4种并发症的独立危险因素，女性是UTI发生的独立危险因素。男性患者术后比女性患者更易发生更多并发症。尽管发生并发症的可能性相对较低，但骨科医生在为接受翻修TKA的患者提供咨询时，应意识到术后并发症发生率会增加。
