Department of Orthopedic Surgery, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Wai Nan Guo Xue Lane No. 37, Wuhou District, Chengdu, Sichuan Province, 610041, PR China.
Department of Orthopedic Surgery, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Wai Nan Guo Xue Lane No. 37, Wuhou District, Chengdu, Sichuan Province, 610041, PR China.
Int J Surg. 2020 May;77:163-172. doi: 10.1016/j.ijsu.2020.03.053. Epub 2020 Apr 2.
Currently, no meta-analysis exists to elucidate the outcomes of primary total knee arthroplasty (TKA) in patients with post-traumatic arthritis (PTA). The primary aim of this meta-analysis was to compare revision and complication rates for patients with PTA versus osteoarthritis (OA).
The following databases were used for searching existing literature (from their inception to October 2019): PubMed, Scopus, EMBASE, Cochrane Library, and Web of Science. The primary outcomes were the incidences of revision and complications, Secondary outcomes included operative time and patient-reported outcomes (PRO) scores.
Nine studies with a total of 6,783,990 patients were included. This study found that there was a statistically significant difference in the rates of superficial wound infection, periprosthetic infection, stiffness, wound complications, and revision, with these outcomes occurring more frequently in patients with PTA. However, PTA did not increase the risks for periprosthetic fracture, aseptic loosening or instability, and VTE. Moreover, PTA was associated with increased operative time, worse postoperative PRO scores, and similar changes in PRO scores.
This meta-analysis highlight the complexity of PTA and demonstrates increased risks of infection, wound complications, stiffness, and revision. Surgeons can use this information to help aid in counseling patients preoperatively.
目前，尚无荟萃分析阐明创伤后关节炎（PTA）患者初次全膝关节置换术（TKA）的结果。本次荟萃分析的主要目的是比较 PTA 与骨关节炎（OA）患者的翻修率和并发症发生率。
本研究检索了从文献起源至 2019 年 10 月的现有文献，使用的数据库包括 PubMed、Scopus、EMBASE、Cochrane Library 和 Web of Science。主要结局指标为翻修和并发症发生率，次要结局指标包括手术时间和患者报告的结局（PRO）评分。
共纳入 9 项研究，总计 6783990 例患者。本研究发现，浅表伤口感染、假体周围感染、僵硬、伤口并发症和翻修的发生率存在统计学显著差异，PTA 患者的这些结果更为常见。然而，PTA 并未增加假体周围骨折、无菌性松动或不稳定以及静脉血栓栓塞的风险。此外，PTA 与手术时间延长、术后 PRO 评分较差以及 PRO 评分相似的变化相关。
本荟萃分析强调了 PTA 的复杂性，并表明感染、伤口并发症、僵硬和翻修的风险增加。外科医生可以利用这些信息来帮助患者进行术前咨询。
