关节镜检查与切开手术治疗化脓性膝关节炎的对比
Arthroscopy versus arthrotomy for the treatment of septic knee arthritis.
作者信息
Johnson Daniel J, Butler Bennet A, Hartwell Matthew J, Fernandez Claire E, Nicolay Richard W, Selley Ryan S, Terry Michael A, Tjong Vehniah K
机构信息
Northwestern University Feinberg School of Medicine, Department of Orthopedic Surgery, USA.
出版信息
J Orthop. 2019 Nov 27;19:46-49. doi: 10.1016/j.jor.2019.11.031. eCollection 2020 May-Jun.
Abstract
PURPOSE
To compare complications following arthroscopy and arthrotomy for treatment of septic knee arthritis.
METHODS
Patients undergoing arthroscopy and arthrotomy for a diagnosis of septic knee arthritis were identified in National Surgical Quality Improvement Program and placed in a multivariate analysis to determine if type of surgery contributed to postoperative complications.
RESULTS
Knee arthrotomy was associated with an increased risk for increased operative time [Parameter estimate 4.555 (95% CI:3.023-6.085); p < 0.0001], minor morbid events [OR 2.064 (95% CI: 1.447-2.943); p < 0.0001], and any morbidity [OR 2.285 (95% CI:1.527-3.419); p < 0.0001].
CONCLUSIONS
Knee arthrotomy was associated with a higher risk of complications.
摘要
目的
比较关节镜检查和切开手术治疗化脓性膝关节炎后的并发症。
方法
在国家外科质量改进计划中确定接受关节镜检查和切开手术以诊断化脓性膝关节炎的患者，并进行多因素分析，以确定手术类型是否会导致术后并发症。
结果
膝关节切开手术与手术时间延长的风险增加相关[参数估计值4.555（95%可信区间：3.023 - 6.085）；p < 0.0001]，轻微不良事件[比值比2.064（95%可信区间：1.447 - 2.943）；p < 0.0001]，以及任何不良事件[比值比2.285（95%可信区间：1.527 - 3.419）；p < 0.0001]。
结论
膝关节切开手术与更高的并发症风险相关。
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本文引用的文献
1
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Orthopedics. 2018 Mar 1;41(2):e184-e188. doi: 10.3928/01477447-20180102-01. Epub 2018 Jan 9.
2
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3
Open Compared with Arthroscopic Treatment of Acute Septic Arthritis of the Native Knee.
J Bone Joint Surg Am. 2017 Mar 15;99(6):499-505. doi: 10.2106/JBJS.16.00110.
4
Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.
Orthopedics. 2016 Jan-Feb;39(1):50-4. doi: 10.3928/01477447-20151222-05. Epub 2015 Dec 30.
5
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6
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Knee Surg Sports Traumatol Arthrosc. 2016 Oct;24(10):3147-3154. doi: 10.1007/s00167-015-3659-8. Epub 2015 May 28.
7
Risk factors for failure of a single surgical debridement in adults with acute septic arthritis.
J Bone Joint Surg Am. 2015 Apr 1;97(7):558-64. doi: 10.2106/JBJS.N.00593.
8
Efficacy of arthroscopic treatment for resolving infection in septic arthritis of native joints.
Orthop Traumatol Surg Res. 2015 Feb;101(1):61-4. doi: 10.1016/j.otsr.2014.11.010. Epub 2015 Jan 23.
9
Septic arthritis.
Best Pract Res Clin Rheumatol. 2011 Jun;25(3):407-21. doi: 10.1016/j.berh.2011.02.001.
10
The relation between the arthroscopic findings and functional outcomes in patients with septic arthritis of the knee joint, treated with arthroscopic debridement and irrigation.
Acta Orthop Traumatol Turc. 2011;45(2):94-9. doi: 10.3944/AOTT.2011.2258.
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