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糖尿病并不会增加全膝关节置换术后膝关节僵硬的风险：一项纳入246053例病例的7项研究的荟萃分析。

Diabetes mellitus does not increase the risk of knee stiffness after total knee arthroplasty: a meta-analysis of 7 studies including 246 053 cases.

作者信息

Jump Christopher, Malik Rayaz A, Anand Anoop, Charalambous Charalambos P

机构信息

Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool, UK.

Weill Cornell Medical College, Doha, Qatar.

出版信息

Knee Surg Relat Res. 2019 Jul 17;31(1):6. doi: 10.1186/s43019-019-0004-4.

DOI:10.1186/s43019-019-0004-4
PMID:32660554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7219526/
Abstract

PURPOSE

The association of diabetes mellitus with knee stiffness after total knee arthroplasty is still being debated. The aim of this study was to assess through meta-analysis the impact of diabetes mellitus on the prevalence of postoperative knee stiffness after total knee arthroplasty.

METHODS

We conducted a literature search for terms regarding postoperative knee stiffness and diabetes mellitus on Embase, CINAHL, and PubMed NCBI.

RESULTS

Of 1142 articles, seven were suitable for analysis. Meta-analysis showed that diabetes mellitus does not confer an increased risk of primary or revision total knee arthroplasty-induced postoperative knee stiffness when compared to nondiabetic patients (primary total knee arthroplasty, estimated odds ratio [OR] 1.474 and 95% confidence interval [CI] 0.97-2.23; primary and revision total knee arthroplasty, OR 1.340 and 95% CI 0.97-1.83).

CONCLUSION

There is no strong evidence that diabetes mellitus increases the risk of knee stiffness after total knee arthroplasty. The decision to proceed with total knee arthroplasty, discussion as part of the consent process, and subsequent rehabilitation should not differ between patients with and without diabetes mellitus with regards to risk of stiffness.

LEVEL OF EVIDENCE

Level III (meta-analysis).

摘要

目的

糖尿病与全膝关节置换术后膝关节僵硬之间的关联仍存在争议。本研究的目的是通过荟萃分析评估糖尿病对全膝关节置换术后膝关节僵硬发生率的影响。

方法

我们在Embase、CINAHL和PubMed NCBI上搜索了有关术后膝关节僵硬和糖尿病的术语。

结果

在1142篇文章中，有7篇适合分析。荟萃分析表明，与非糖尿病患者相比，糖尿病并不会增加初次或翻修全膝关节置换术后膝关节僵硬的风险（初次全膝关节置换术，估计比值比[OR]为1.474，95%置信区间[CI]为0.97 - 2.23；初次和翻修全膝关节置换术，OR为1.340，95%CI为0.97 - 1.83）。

结论

没有充分证据表明糖尿病会增加全膝关节置换术后膝关节僵硬的风险。对于有或没有糖尿病的患者，在决定进行全膝关节置换术、作为同意过程一部分进行讨论以及后续康复时，就僵硬风险而言不应有所不同。

证据级别

III级（荟萃分析）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/f2d71db5adf1/43019_2019_4_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/1242a578c92d/43019_2019_4_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/6102e6e9361a/43019_2019_4_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/a20fe6a00fcf/43019_2019_4_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/f2d71db5adf1/43019_2019_4_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/1242a578c92d/43019_2019_4_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/6102e6e9361a/43019_2019_4_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/a20fe6a00fcf/43019_2019_4_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004f/7219526/f2d71db5adf1/43019_2019_4_Fig4_HTML.jpg

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