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全膝关节置换术中组件大小能否术前预测?——患者特征分析。

Can Component Size in Total Knee Arthroplasty Be Predicted Preoperatively?-An Analysis of Patient Characteristics.

机构信息

Department of Orthopedic Surgery, Northwell Orthopedic Institute, Lenox Hill Hospital, New York, New York.

Department of Orthopedic Surgery, Mercy Health, St Vincent Medical Center, Toledo, Ohio.

出版信息

J Knee Surg. 2023 Jul;36(9):965-970. doi: 10.1055/s-0042-1748902. Epub 2022 Jul 12.

Abstract

Accurately predicting component sizing in total knee arthroplasty (TKA) can ensure appropriate implants are readily available, avoiding complications from malsizing while also reducing cost by improving workflow efficiency through a reduction in instrumentation. This study investigated the utility of demographic variables to reliably predict TKA component sizes. A retrospective chart review of 337 patients undergoing primary TKA was performed. Patient characteristics (age, sex, race, height, weight) were recorded along with implant and shoe size. Correlation between shoe size and TKA component size was assessed using Pearson's correlation coefficient and linear regression analysis using three models: (A) standard demographic variables, (B) shoe size, and (C) combination of both models. Shoe size demonstrated the strongest correlation with femoral anteroposterior (FAP) ( < 0.001) followed by height ( < 0.001). Conversely, height exhibited the strongest correlation with tibial mediolateral (TML) ( < 0.001) followed by shoe size ( < 0.001). Model C was able to correctly predict both the femur and tibia within one and two sizes in 83.09 and 98.14% of cases, respectively. Individually, model C predicted the FAP within one and two sizes in 83.09 and 96.14% of cases, and the TML in 98.81 and 100% of cases, respectively. A patient's shoe size demonstrates a strong correlation to the TKA implant size, and when combined with standard demographic variables the predictive reliability is further increased. Here, we present a predictive model for implant sizing based solely on easily attainable demographic variables, that will be useful for preoperative planning to improve surgical efficiency. LEVEL OF EVIDENCE:  II, Diagnostic.

摘要

准确预测全膝关节置换术(TKA)中的组件尺寸可以确保有合适的植入物随时可用,避免因尺寸不合适而产生并发症,同时通过提高工作流程效率来降低成本,减少器械的使用。本研究探讨了使用人口统计学变量可靠预测 TKA 组件尺寸的效用。对 337 例接受初次 TKA 的患者进行了回顾性图表审查。记录了患者特征(年龄、性别、种族、身高、体重)以及植入物和鞋码。使用 Pearson 相关系数评估了鞋码与 TKA 组件尺寸之间的相关性,并使用三种模型(A)标准人口统计学变量、(B)鞋码和(C)两种模型的组合进行线性回归分析。鞋码与股骨前后向(FAP)的相关性最强(<0.001),其次是身高(<0.001)。相反,身高与胫骨内外侧(TML)的相关性最强(<0.001),其次是鞋码(<0.001)。模型 C 能够正确预测 83.09%和 98.14%的股骨和胫骨的一个和两个尺寸。单独来看,模型 C 预测 FAP 的一个和两个尺寸的比例分别为 83.09%和 96.14%,TML 的比例分别为 98.81%和 100%。患者的鞋码与 TKA 植入物尺寸之间存在很强的相关性,当与标准人口统计学变量结合使用时,预测的可靠性进一步提高。在这里,我们提出了一种仅基于易于获得的人口统计学变量的植入物尺寸预测模型,这将有助于术前计划,以提高手术效率。证据水平:Ⅱ,诊断。

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