• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

病态肥胖患者全膝关节置换术后的中长期并发症及预后：一项系统评价和荟萃分析

Mid- to long-term complications and outcome for morbidly obese patients after total knee arthroplasty: a systematic review and meta-analysis.

作者信息

van Tilburg Joost, Rathsach Andersen Mikkel

机构信息

Department of Orthopedics, Herlev Gentofte Hospital, Hellerup, Copenhagen, Denmark.

出版信息

EFORT Open Rev. 2022 May 5;7(5):295-304. doi: 10.1530/EOR-21-0090.

DOI:10.1530/EOR-21-0090
PMID:35510746
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9142821/
Abstract

PURPOSE

Due to substantial increase in obesity, the demand for total knee arthroplasty (TKA) in obese and morbidly obese patients is higher than ever. This review aims to investigate mid- to long-term complications, revision rates, and outcome for morbidly obese, compared with non-obese after TKA.

METHODS

A systematic search was conducted in May 2021. Included studies reported revision rates for morbidly obese and non-obese with a mean follow-up of at least 2 years. Reported knee society score (KSS) has been used to compare the functional outcome. PRISMA protocol was followed, and PROSPERO registered (ID: CRD42021254119).

RESULTS

From 12 studies that met the inclusion criteria, a total of 1031 cases of morbidly obese and 9797 cases of non-obese controls were included. The risk ratio for revision was 1.48 for the morbidly obese, compared with non-obese (95% CI: 0.98 to 2.24; P = 0.06). Regarding aseptic and septic revision, the risk ratio was 1.44 (95% CI: 0.64 to 3.25; P = 0.37) and 2.22 (95% CI: 0.89 to 5.57; P = 0.09), respectively. The morbidly obese scored lower in Objective Knee Society Score (OKSS) and Functional Knee Society Score (FKSS) both preoperatively and postoperatively, compared with the non-obese; however, the two groups improved equally in function scores OKSS (P= 0.967) and FKSS (P = 0.834). Overall risk ratio for complications was 1.56 (95% CI: 0.98 to 2.48; P = 0.06).

CONCLUSIONS

The gained benefit in functional outcome surpasses the increase in risk of revision and complications for the morbidly obese in TKA surgery.

摘要

目的

由于肥胖率大幅上升，肥胖和病态肥胖患者对全膝关节置换术（TKA）的需求比以往任何时候都更高。本综述旨在研究与非肥胖患者相比，病态肥胖患者TKA术后的中长期并发症、翻修率及预后情况。

方法

于2021年5月进行了系统检索。纳入的研究报告了病态肥胖和非肥胖患者的翻修率，平均随访时间至少为2年。采用报告的膝关节协会评分（KSS）来比较功能结局。遵循PRISMA方案，并在PROSPERO注册（注册号：CRD42021254119）。

结果

从12项符合纳入标准的研究中，共纳入1031例病态肥胖患者和9797例非肥胖对照患者。与非肥胖患者相比，病态肥胖患者的翻修风险比为1.48（95%可信区间：0.98至2.24；P = 0.06）。关于无菌性和感染性翻修，风险比分别为1.44（95%可信区间：0.64至3.25；P = 0.37）和2.22（95%可信区间：0.89至5.57；P = 0.09）。与非肥胖患者相比，病态肥胖患者术前和术后的客观膝关节协会评分（OKSS）和功能膝关节协会评分（FKSS）均较低；然而，两组在功能评分OKSS（P = 0.967）和FKSS（P = 0.834）方面的改善程度相同。并发症的总体风险比为1.56（95%可信区间：0.98至2.48；P = 0.06）。

结论

在TKA手术中，病态肥胖患者在功能结局方面获得的益处超过了翻修和并发症风险的增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/1180ba18dff8/EOR-21-0090fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/fc06d707c1c4/EOR-21-0090fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/b5d709544a34/EOR-21-0090fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/ed95d5385e57/EOR-21-0090fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/26791843a73d/EOR-21-0090fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/00f7ff75240a/EOR-21-0090fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/1180ba18dff8/EOR-21-0090fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/fc06d707c1c4/EOR-21-0090fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/b5d709544a34/EOR-21-0090fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/ed95d5385e57/EOR-21-0090fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/26791843a73d/EOR-21-0090fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/00f7ff75240a/EOR-21-0090fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0141/9142821/1180ba18dff8/EOR-21-0090fig6.jpg

相似文献

1
Mid- to long-term complications and outcome for morbidly obese patients after total knee arthroplasty: a systematic review and meta-analysis.病态肥胖患者全膝关节置换术后的中长期并发症及预后：一项系统评价和荟萃分析
EFORT Open Rev. 2022 May 5;7(5):295-304. doi: 10.1530/EOR-21-0090.
2
The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature.病态肥胖患者全膝关节置换术的结果：文献系统综述
Arch Orthop Trauma Surg. 2019 Apr;139(4):553-560. doi: 10.1007/s00402-019-03127-5. Epub 2019 Feb 16.
3
Revision Rates and Functional Outcomes Among Severely, Morbidly, and Super-Obese Patients Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.初次全膝关节置换术后重度、病态肥胖和超级肥胖患者的翻修率及功能结局：一项系统评价和荟萃分析
JBJS Rev. 2019 Jul;7(7):e9. doi: 10.2106/JBJS.RVW.18.00184.
4
The effect of morbid obesity (BMI ≥ 35 kg/m) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study.病态肥胖（BMI≥35kg/m）对单髁膝关节置换术后功能结果和并发症发生率的影响：一项病例对照研究。
J Orthop Surg Res. 2019 Aug 22;14(1):266. doi: 10.1186/s13018-019-1316-5.
5
Morbid obesity: a significant risk factor for failure of two-stage revision total knee arthroplasty for infection.病态肥胖：二期翻修全膝关节置换术治疗感染失败的显著危险因素。
J Bone Joint Surg Am. 2014 Sep 17;96(18):e154. doi: 10.2106/JBJS.M.01289.
6
The influence of body mass index on functional outcome and quality of life after total knee arthroplasty.体重指数对全膝关节置换术后功能结局和生活质量的影响。
Bone Joint J. 2016 Jun;98-B(6):780-5. doi: 10.1302/0301-620X.98B6.35709.
7
Revision Rates and Functional Outcome Scores for Severely, Morbidly, and Super-Obese Patients Undergoing Primary Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.接受初次全髋关节置换术的重度、病态肥胖和超级肥胖患者的翻修率及功能结局评分：一项系统评价和荟萃分析
JBJS Rev. 2019 Apr;7(4):e11. doi: 10.2106/JBJS.RVW.18.00118.
8
Ten-Year Mortality and Revision After Total Knee Arthroplasty in Morbidly Obese Patients.肥胖患者全膝关节置换术后 10 年死亡率和翻修率。
J Arthroplasty. 2018 Aug;33(8):2518-2523. doi: 10.1016/j.arth.2018.03.049. Epub 2018 Apr 4.
9
Does experience with total knee arthroplasty in morbidly obese patients effect surgical outcomes.肥胖患者全膝关节置换术的经验是否会影响手术结果。
Arch Orthop Trauma Surg. 2024 Jan;144(1):385-392. doi: 10.1007/s00402-023-05053-z. Epub 2023 Sep 27.
10
Does Obesity Have an Effect on the Outcomes of Unicondylar Knee Arthroplasty in Patients with Isolated Medial Gonarthrosis?肥胖对单纯内侧间室骨关节炎患者行单髁膝关节置换术的结局是否有影响？
Acta Chir Orthop Traumatol Cech. 2021;88(4):302-306.

引用本文的文献

1
Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity-score matched study.全膝关节置换术对膝关节骨关节炎患者5年症状、功能及活动的影响：一项倾向评分匹配研究
J Exp Orthop. 2025 Mar 22;12(1):e70185. doi: 10.1002/jeo2.70185. eCollection 2025 Jan.
2
A survey of Scottish Committee for Orthopaedics and Trauma members on lower limb joint replacement practices in morbidly obese patients.一项针对苏格兰骨科与创伤委员会成员关于病态肥胖患者下肢关节置换手术实践的调查。
J Clin Orthop Trauma. 2024 Dec 4;61:102855. doi: 10.1016/j.jcot.2024.102855. eCollection 2025 Feb.
3

本文引用的文献

1
Reduced Aseptic Loosening With Fully Cemented Short-Stemmed Tibial Components in Primary Cemented Total Knee Arthroplasty.在初次骨水泥型全膝关节置换术中，使用全骨水泥固定的短柄胫骨组件可减少无菌性松动。
J Arthroplasty. 2020 Jun;35(6):1591-1594.e3. doi: 10.1016/j.arth.2020.01.084. Epub 2020 Feb 7.
2
Preoperative Weight Loss for Morbidly Obese Patients Undergoing Total Knee Arthroplasty: Determining the Necessary Amount.接受全膝关节置换术的病态肥胖患者的术前减重：确定必要的减重幅度。
J Bone Joint Surg Am. 2019 Aug 21;101(16):1440-1450. doi: 10.2106/JBJS.18.01136.
3
Long-term outcome of total knee arthroplasty in patients with morbid obesity.
Optimal timing of hip and knee arthroplasty after bariatric surgery: A systematic review.
减肥手术后髋膝关节置换术的最佳时机：一项系统评价
J Clin Orthop Trauma. 2024 Apr 26;52:102423. doi: 10.1016/j.jcot.2024.102423. eCollection 2024 May.
4
Body Mass Index Did Not Affect the Risk of Revision 3-9 Years After Total Knee Replacement Surgery.体重指数不影响全膝关节置换术后3至9年翻修手术的风险。
Arthroplast Today. 2024 Apr 16;27:101376. doi: 10.1016/j.artd.2024.101376. eCollection 2024 Jun.
5
Total Knee Arthroplasty with Non-Stemmed Tibial Components among Obese Patients: Clinical and Radiologic Evaluation and Review of Literature.肥胖患者使用非柄型胫骨组件的全膝关节置换术：临床和影像学评估及文献综述
Bull Emerg Trauma. 2023;11(2):69-74. doi: 10.30476/BEAT.2023.98166.1420.
肥胖患者行全膝关节置换术的长期疗效。
Int Orthop. 2020 Jan;44(1):95-104. doi: 10.1007/s00264-019-04378-y. Epub 2019 Aug 2.
4
Revision Rates and Functional Outcomes Among Severely, Morbidly, and Super-Obese Patients Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.初次全膝关节置换术后重度、病态肥胖和超级肥胖患者的翻修率及功能结局：一项系统评价和荟萃分析
JBJS Rev. 2019 Jul;7(7):e9. doi: 10.2106/JBJS.RVW.18.00184.
5
The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature.病态肥胖患者全膝关节置换术的结果：文献系统综述
Arch Orthop Trauma Surg. 2019 Apr;139(4):553-560. doi: 10.1007/s00402-019-03127-5. Epub 2019 Feb 16.
6
Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty.肥胖患者预防性胫骨柄固定：初次全膝关节置换术的早期比较结果
Knee Surg Relat Res. 2018 Sep 1;30(3):227-233. doi: 10.5792/ksrr.18.022.
7
Ninety-Day Costs, Reoperations, and Readmissions for Primary Total Knee Arthroplasty Patients With Varying Body Mass Index Levels.不同体重指数水平的初次全膝关节置换术患者的 90 天费用、再手术和再入院情况。
J Arthroplasty. 2018 Jul;33(7S):S157-S161. doi: 10.1016/j.arth.2018.02.019. Epub 2018 Feb 15.
8
Maximum lifetime body mass index is the appropriate predictor of knee and hip osteoarthritis.最大终生体重指数是膝关节和髋关节骨关节炎的合适预测指标。
Arch Orthop Trauma Surg. 2018 Jan;138(1):99-103. doi: 10.1007/s00402-017-2825-5. Epub 2017 Oct 27.
9
Morbid Obesity and Total Knee Arthroplasty: A Growing Problem.病态肥胖与全膝关节置换术：一个日益严重的问题。
J Am Acad Orthop Surg. 2017 Mar;25(3):188-194. doi: 10.5435/JAAOS-D-15-00684.
10
Operative Time Affects Short-Term Complications in Total Joint Arthroplasty.手术时间影响全关节置换术的短期并发症。
J Arthroplasty. 2017 Apr;32(4):1285-1291. doi: 10.1016/j.arth.2016.12.003. Epub 2016 Dec 14.