Specialist training registrar trauma and orthopaedic surgery, Department of Trauma and Orthopaedic Surgery, Glasgow Royal Infirmary, UK.
Specialist training registrar trauma and orthopaedic surgery, Department of Trauma and Orthopaedic Surgery, Royal Alexandra Hospital Paisley, UK.
Scott Med J. 2020 Aug;65(3):89-93. doi: 10.1177/0036933020936282. Epub 2020 Jun 28.
The aim of this large population based study was to investigate the effect of patient age and gender on the complication rates of knee arthroplasty surgery using data from the Scottish Arthroplasty Project joint registry.
55,636 knee arthroplasty procedures were included in the study and divided into four age categories (<55, 55-64, 65-75 and >75 years) for comparison of the 90-day deep vein thrombosis or pulmonary embolism (DVT/PE) and one-year infection rates and the mortality and revision rates up to ten-year follow up. The mean rate of DVT/PE was 1.4% with significantly higher rates in elderly patients (p = 0.0006). The mean one-year infection rate was 1.6% with a significantly increased rate of 1.9% in males (p = 0.0001). Mortality rates increased with age, the 10-year mortality in patients >75 years of age was 44.8%. Revision rates were increased in males and younger patients.
Elderly patients showed higher rates of thromboembolic complications. There was no difference in infection rates between different age groups. The infection rate was higher in males. Younger patients need to be counselled about the increased risk of revision at 10 years.
本大规模基于人群的研究旨在利用苏格兰关节置换项目联合登记处的数据,调查患者年龄和性别对膝关节置换手术并发症发生率的影响。
本研究纳入了 55636 例膝关节置换手术,并分为四个年龄组(<55 岁、55-64 岁、65-75 岁和>75 岁),比较 90 天深静脉血栓形成或肺栓塞(DVT/PE)和 1 年感染率以及 10 年随访的死亡率和翻修率。DVT/PE 的平均发生率为 1.4%,老年患者的发生率明显更高(p=0.0006)。1 年感染率的平均发生率为 1.6%,男性感染率显著增加(1.9%)(p=0.0001)。死亡率随年龄增长而增加,>75 岁患者的 10 年死亡率为 44.8%。翻修率在男性和年轻患者中增加。
老年患者发生血栓栓塞性并发症的风险较高。不同年龄组之间的感染率没有差异。男性的感染率更高。需要告知年轻患者,他们在 10 年内翻修的风险增加。