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门诊全膝关节置换术:是否值得考虑?

Outpatient total knee arthroplasty: is it worth considering?

作者信息

Rodríguez-Merchán E Carlos

机构信息

Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain.

出版信息

EFORT Open Rev. 2020 Mar 2;5(3):172-179. doi: 10.1302/2058-5241.5.180101. eCollection 2020 Mar.

Abstract

Some authors have reported that outpatient total knee arthroplasty (TKA) is a successful, safe and cost-effective treatment in the management of advanced osteoarthritis.The success obtained has been attributed to the coordination of the multidisciplinary team, standardized perioperative protocols, optimal hospital discharge planning and careful selection of patients.One study has demonstrated a higher risk of perioperative surgical and medical outcomes in outpatient TKA than inpatient TKA, including component failure, surgical site infection, knee stiffness and deep vein thrombosis.There remains a lack of universal criteria for patient selection. Outpatient TKA has thus far been performed in relatively young patients with few comorbidities.It is not yet clear whether outpatient TKA is worth considering, except in very exceptional cases (young patients without associated comorbidities).Outpatient TKA should not be generally recommended at the present time. Cite this article: 2020;5:172-179. DOI: 10.1302/2058-5241.5.180101.

摘要

一些作者报告称,门诊全膝关节置换术(TKA)是治疗晚期骨关节炎的一种成功、安全且具有成本效益的方法。所取得的成功归因于多学科团队的协作、标准化的围手术期方案、优化的出院计划以及对患者的精心挑选。一项研究表明,门诊TKA的围手术期手术和医疗结果风险高于住院TKA,包括假体失败、手术部位感染、膝关节僵硬和深静脉血栓形成。目前仍缺乏通用的患者选择标准。迄今为止,门诊TKA主要在合并症较少的相对年轻患者中进行。除了极少数情况(无相关合并症的年轻患者)外,门诊TKA是否值得考虑尚不清楚。目前一般不建议进行门诊TKA。引用本文:2020;5:172 - 179。DOI:10.1302/2058 - 5241.5.180101。

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