Department of Orthopaedic Surgery, Level 7, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
Edinburgh Orthopaedics Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
Knee. 2022 Jan;34:279-287. doi: 10.1016/j.knee.2022.01.004. Epub 2022 Jan 29.
The aim was to describe temporal changes and associated changes in patient demographics and surgical variables, revision rate and factors associated with revision of primary hinge knee arthroplasty (HKA) in the UK.
National Joint Registry data for England, Wales, Northern Ireland and Isle of Mann was used to examine the temporal trends in patient demographics, surgical factors and indications for primary HKA usage over a 16-year (2003 to 2018) period and associated risk factors for revision.
There were 4921 patient episodes with a median follow up of 5.5 (range 0 to 16.3) years. The median age was 75years and the majority were female (72.9%). There was a tenfold increase in the use of HKA (p < 0.001), with an increased relative usage in female patients (p = 0.010), but no significant changes in age (p = 0.484) or BMI (p = 0.781). There were 227 revisions performed at a median of 695days. The overall unadjusted probabilities of revision at 1, 5 and 10 years were 1.5% (95% confidence intervals (CI) 1.1to1.8), 4.4% (95%CI 3.7 to 5.0) and 6.4% (95%CI 5.5 to 7.3), respectively. Cox proportional hazard analysis demonstrated younger age (p < 0.01), male sex (hazard ratio (HR) 1.43, p < 0.01), morbid obesity (HR 2.31, p = 0.022) or previous trauma as the indication (HR 1.48, p = 0.025) were associated with an increased risk of revision.
There was an increase in the use of HKA with increased uptake among female patients. The revision rate was a 6.4% at 10 years, however, younger age, male sex, morbid obesity or previous trauma were associated with an increased risk of revision.
III Retrospective study.
本研究旨在描述英国初次铰链膝关节置换术（HKA）的时间变化以及与患者人口统计学和手术变量、翻修率相关的变化，同时分析初次 HKA 使用的相关因素和翻修的影响因素。
利用英国国家关节登记处（National Joint Registry）的数据，对英格兰、威尔士、北爱尔兰和马恩岛 16 年间（2003 年至 2018 年）患者人口统计学、手术因素和初次 HKA 使用指征的时间变化趋势进行了研究，并分析了翻修的相关危险因素。
共纳入 4921 例患者，平均随访 5.5 年（0 至 16.3 年）。患者的中位年龄为 75 岁，大多数为女性（72.9%）。初次 HKA 的使用率增长了十倍（p＜0.001），女性患者的相对使用率增加（p=0.010），但年龄（p=0.484）或 BMI（p=0.781）无显著变化。术后中位 695 天进行了 227 次翻修。1、5 和 10 年的未调整翻修率分别为 1.5%（95%置信区间 1.1%至 1.8%）、4.4%（95%置信区间 3.7%至 5.0%）和 6.4%（95%置信区间 5.5%至 7.3%）。Cox 比例风险分析表明，年龄较小（p＜0.01）、男性（风险比 1.43，p＜0.01）、病态肥胖（HR 2.31，p=0.022）或既往创伤为适应证（HR 1.48，p=0.025）与翻修风险增加相关。
初次 HKA 的使用呈上升趋势，女性患者的使用率增加。10 年的翻修率为 6.4%，然而，年龄较小、男性、病态肥胖或既往创伤与翻修风险增加相关。
III 级回顾性研究。
