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本文引用的文献

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Comparison of Floseal® and Tranexamic Acid for Bleeding Control after Total Knee Arthroplasty: a Prospective Randomized Study.Floseal®与氨甲环酸在全膝关节置换术后止血效果的比较:一项前瞻性随机研究。
Clinics (Sao Paulo). 2019 Nov 25;74:e1186. doi: 10.6061/clinics/2019/e1186. eCollection 2019.
2
Comparison of the Efficacy Between Closed Incisional Negative-Pressure Wound Therapy and Conventional Wound Management After Total Hip and Knee Arthroplasties: A Systematic Review and Meta-Analysis.关节置换术后闭合性切口负压伤口治疗与常规伤口管理疗效比较的系统评价和荟萃分析。
J Arthroplasty. 2019 Nov;34(11):2804-2814. doi: 10.1016/j.arth.2019.06.020. Epub 2019 Jun 19.
3
Posterior versus direct anterior approach in total hip arthroplasty: difference in patient-reported outcomes measured with the Forgotten Joint Score-12.全髋关节置换术中后外侧入路与直接前侧入路的比较:采用遗忘关节评分-12评估的患者报告结局差异
SICOT J. 2018;4:54. doi: 10.1051/sicotj/2018051. Epub 2016 Nov 27.
4
Electric cautery does not reduce blood loss in primary total knee arthroplasty compared with scalpel only surgery a double-blinded randomized controlled trial.电灼术与仅使用手术刀的手术相比,并未减少初次全膝关节置换术的失血量:一项双盲随机对照试验。
Int Orthop. 2018 Dec;42(12):2755-2760. doi: 10.1007/s00264-018-4048-y. Epub 2018 Jul 3.
5
NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY.负压伤口治疗在全膝关节置换术后复杂损伤治疗中的应用
Acta Ortop Bras. 2017 Mar-Apr;25(2):85-88. doi: 10.1590/1413-785220172502169053.
6
Topical versus intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials.全膝关节置换术中局部应用与静脉应用氨甲环酸的比较:一项随机对照试验的荟萃分析
Int Orthop. 2017 Apr;41(4):739-748. doi: 10.1007/s00264-016-3296-y. Epub 2016 Nov 11.
7
Harmonic Scalpel versus Monopolar Electrocauterization in Cholecystectomy.胆囊切除术中谐波手术刀与单极电灼术的比较
JSLS. 2016 Jul-Sep;20(3). doi: 10.4293/JSLS.2016.00037.
8
Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial.常规初次髋关节和膝关节置换术中使用切口负压伤口治疗敷料(iNPWTd):一项随机对照试验。
Bone Joint Res. 2016 Aug;5(8):328-37. doi: 10.1302/2046-3758.58.BJR-2016-0022.R1.
9
Thrombin-Based Hemostatic Agent in Primary Total Knee Arthroplasty.基于凝血酶的止血剂在初次全膝关节置换术中的应用
J Knee Surg. 2017 Feb;30(2):121-127. doi: 10.1055/s-0036-1582137. Epub 2016 Apr 18.
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Does knee awareness differ between different knee arthroplasty prostheses? A matched, case-control, cross-sectional study.不同膝关节置换假体之间的膝关节感知觉是否存在差异?一项匹配的病例对照横断面研究。
BMC Musculoskelet Disord. 2016 Apr 1;17:141. doi: 10.1186/s12891-016-1001-3.

在初次全膝关节置换术中,手术刀相较于电烙术能取得更好的临床效果:一项对比研究。

Scalpel can achieve better clinical outcomes compared with electric cautery in primary total knee arthroplasty: a comparison study.

机构信息

Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2020 Jun 29;21(1):409. doi: 10.1186/s12891-020-03457-1.

DOI:10.1186/s12891-020-03457-1
PMID:32600294
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7325273/
Abstract

BACKGROUND

Whether using the scalpel can provide better and faster recovery after the primary total knee arthroplasty (TKA) is still controversial. The aim of this research was to compare the clinical outcomes of using the scalpel and the electric cautery in primary TKA.

METHODS

From January 2016 to December 2017, a retrospective cohort study was conducted in 313 patients who underwent unilateral primary TKA by using the scalpel (group S). During this period, we selected 313 patients who underwent unilateral primary TKA by using the electric cautery (group E) for comparison. The tourniquet time, operative time, blood loss, wound complications, visual analog score for pain, range of motion, Knee Society Score were assessed between the two groups. The Forgotten Joint Score was used to analyze the ability to forget the joint.

RESULTS

There were no significant differences in tourniquet time, operative time, blood loss between the two groups (p > 0.05). In the group S, the visual analog score for pain, range of motion, Knee Society Score were found better results at 1 week, 1 month, 3 months, 6 months, 12 months and 24 months after surgery (p < 0.05). Besides, during the follow-up period, the Forgotten Joint Score was significantly higher compared with group E (p < 0.05).

CONCLUSION

In this research, the patients who underwent TKA by using the scalpel could achieve better clinical outcomes. In addition, if forgotten artificial joint after TKA was the final goal, the patients who underwent TKA by using the scalpel would acquire better quality of life.

摘要

背景

在初次全膝关节置换术(TKA)后使用手术刀是否能提供更好、更快的恢复仍然存在争议。本研究的目的是比较使用手术刀和电刀进行初次 TKA 的临床效果。

方法

本回顾性队列研究纳入了 2016 年 1 月至 2017 年 12 月间接受单侧初次 TKA 的 313 例患者(使用手术刀组,S 组)。在此期间,我们选择了同期接受单侧初次 TKA 的 313 例患者(使用电刀组,E 组)进行比较。比较两组患者的止血带时间、手术时间、失血量、伤口并发症、疼痛视觉模拟评分(VAS)、关节活动度、膝关节学会评分(KSS)。采用遗忘关节评分(FJS)分析关节遗忘能力。

结果

两组患者的止血带时间、手术时间、失血量差异均无统计学意义(p>0.05)。S 组患者在术后 1 周、1 个月、3 个月、6 个月、12 个月和 24 个月时 VAS、关节活动度、KSS 评分均明显更好(p<0.05)。随访期间,FJS 评分明显高于 E 组(p<0.05)。

结论

在本研究中,使用手术刀进行 TKA 的患者可获得更好的临床效果。此外,如果 TKA 后忘记人工关节是最终目标,那么使用手术刀进行 TKA 的患者将获得更好的生活质量。