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反式肩关节置换术因感染而需要翻修的风险高于解剖型肩关节置换术:来自北欧关节置换注册协会的 17730 例初次肩关节置换术。

Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty: 17 730 primary shoulder arthroplasties from the Nordic Arthroplasty Register Association.

机构信息

Department of Orthopaedic Surgery, Zealand University Hospital, Department of Clinical Medicine, University of Copenhagen, Koege, Denmark.

Department of Orthopaedic Surgery, Herlev and Gentofte University Hospital, Department of Clinical Medicine, University of Copenhagen, Herlev, Denmark.

出版信息

Bone Joint J. 2019 Jun;101-B(6):702-707. doi: 10.1302/0301-620X.101B6.BJJ-2018-1348.R1.

Abstract

AIMS

The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty.

PATIENTS AND METHODS

We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) data set. With the Kaplan-Meier method, we illustrated the ten-year cumulative rates of revision due to infection and with the Cox regression model, we reported the hazard ratios as a measure of the relative risk of revision due to infection.

RESULTS

In all, 188 revisions were reported due to infection during a mean follow-up of three years and nine months. The ten-year cumulative rate of revision due to infection was 1.4% overall, but 3.1% for reverse shoulder arthroplasties and 8.0% for reverse shoulder arthroplasties in men. Reverse shoulder arthroplasties were associated with an increased risk of revision due to infection also when adjusted for sex, age, primary diagnosis, and year of surgery (relative risk 2.41 (95% confidence interval 1.26 to 5.59); p = 0.001).

CONCLUSION

The overall incidence of revision due to infection was low. The increased risk in reverse shoulder arthroplasty must be borne in mind, especially when offering it to men. Cite this article: 2019;101-B:702-707.

摘要

目的

本研究旨在利用国家注册数据库信息,估计感染后行反肩关节置换术的翻修率及感染相关相对风险。

患者与方法

我们纳入了 2004 年至 2013 年期间在北欧关节置换注册协会(NARA)数据库中记录的 17730 例初次肩关节置换术。采用 Kaplan-Meier 法展示了 10 年因感染而翻修的累计发生率,并用 Cox 回归模型报告了感染相关的危险比(HR)作为感染后翻修的相对风险的衡量指标。

结果

平均随访 3 年 9 个月期间,共报告了 188 例因感染而行翻修。总的 10 年因感染而翻修的累计发生率为 1.4%,但反肩关节置换术为 3.1%,男性反肩关节置换术为 8.0%。反肩关节置换术与感染相关的翻修风险增加有关,即使调整了性别、年龄、初次诊断和手术年份(相对风险 2.41(95%置信区间 1.26 至 5.59);p=0.001)。

结论

总体感染相关翻修的发生率较低。反肩关节置换术的风险增加,尤其是在向男性推荐时,必须引起重视。

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