Denyer Steven, Hoyt Aaron K, Schneider Andrew M, Brown Nicholas M
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, IL, USA.
Arthroplast Today. 2023 Jan 28;20:101098. doi: 10.1016/j.artd.2023.101098. eCollection 2023 Apr.
Knee arthrodesis is predominantly a salvage procedure. In present time, knee arthrodesis is mostly considered for cases of unreconstructable failed total knee arthroplasty after prosthetic joint infection or trauma. Knee arthrodesis has shown better functional outcomes than amputation for these patients but has a high complication rate. The purpose of this study was to characterize the acute surgical risk profile of patients undergoing a knee arthrodesis for any indication.
The American College of Surgeons National Surgical Quality Improvement Program database was queried to determine 30-day outcomes after knee arthrodesis between 2005 and 2020. Demographics, clinical risk factors, and postoperative events were analyzed, along with reoperation and readmission rates.
A total of 203 patients that underwent a knee arthrodesis were identified. Forty-eight percent of patients had at least 1 complication. The most common complication was acute surgical blood loss anemia requiring a blood transfusion (38.4%), followed by organ space surgical site infection (4.9%), superficial surgical site infection (2.5%), and deep vein thrombosis (2.5%). Smoking was associated with higher rates of reoperation and readmission (odds ratio 9, < .01, and odds ratio 6, < .05).
Overall, knee arthrodesis is a salvage procedure that has a high rate of early postoperative complications and is most often performed in patients at higher risk. Early reoperation is strongly associated with a poor preoperative functional status. Smoking places patients at higher risk of early complications.
膝关节融合术主要是一种挽救性手术。目前，膝关节融合术主要用于假体关节感染或创伤后无法重建的全膝关节置换失败病例。对于这些患者，膝关节融合术的功能结局优于截肢术，但并发症发生率较高。本研究的目的是描述因任何适应症接受膝关节融合术患者的急性手术风险特征。
查询美国外科医师学会国家外科质量改进计划数据库，以确定2005年至2020年膝关节融合术后30天的结局。分析了人口统计学、临床风险因素和术后事件，以及再次手术和再入院率。
共确定203例接受膝关节融合术的患者。48%的患者至少发生1种并发症。最常见的并发症是需要输血的急性手术失血贫血（38.4%），其次是器官间隙手术部位感染（4.9%）、浅表手术部位感染（2.5%）和深静脉血栓形成（2.5%）。吸烟与较高的再次手术和再入院率相关（比值比9，P<0.01；比值比6，P<0.05）。
总体而言，膝关节融合术是一种挽救性手术，术后早期并发症发生率高，且最常应用于高危患者。早期再次手术与术前功能状态差密切相关。吸烟使患者发生早期并发症的风险更高。
