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快速通道下单髁膝关节置换术后的并发症:170 例前瞻性队列研究。

Complications after lateral unicompartmental knee arthroplasty in a fast-track setting: a prospective cohort study of 170 procedures.

机构信息

Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre (CORH), Copenhagen University Hospital Hvidovre.

Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen University Hospital, Denmark.

出版信息

Acta Orthop. 2023 Jun 27;94:316-320. doi: 10.2340/17453674.2023.13653.

Abstract

BACKGROUND AND PURPOSE

In existing studies on fasttrack unicompartmental knee arthroplasty (UKA), the majority of surgeries are medial. There are substantial differences between lateral and medial UKA, which is why outcomes cannot automatically be compared. To gain information on the feasibility and safety of fast-track protocols in lateral UKAs, we investigated length of stay (LOS) and early complications after lateral UKA, performed using a fast-track protocol in well-established fast-track centers.

PATIENTS AND METHODS

We retrospectively evaluated prospectively collected data on patients undergoing lateral UKA in a fast-track setup from 2010 to 2018 at 7 Danish fast-track centers. Data on patient characteristics, LOS, complications, reoperations, and revisions was analyzed using descriptive statistics. Safety and feasibility were defined as complication and reoperation rates within 90 days comparable to non-fast track lateral UKA or fast-track medial UKA.

RESULTS

We included 170 of patients with a mean age of 66 (SD 12) years. Median LOS was 1 day (interquartile range 1-1), which was unchanged from 2012-2018. 18% were discharged on the day of surgery. Within 90 days, 7 patients experienced medical complications and 5 patients experienced surgical complications. 3 patients underwent reoperation, 2 were soft tissue revisions and the third was removal of an exostosis due to catching of the patella. 1 patient was revised due to a bearing dislocation.

CONCLUSION

Our findings suggest that lateral UKA in a fast-track setting is feasible and safe.

摘要

背景与目的

在现有的快速通道单髁膝关节置换术(UKA)研究中,大多数手术都是内侧的。外侧 UKA 和内侧 UKA 有很大的区别,因此不能自动比较结果。为了了解快速通道方案在外侧 UKA 中的可行性和安全性,我们研究了在既定的快速通道中心采用快速通道方案进行外侧 UKA 后的住院时间(LOS)和早期并发症。

患者与方法

我们回顾性评估了 2010 年至 2018 年在丹麦 7 个快速通道中心采用快速通道方案进行外侧 UKA 的前瞻性收集的数据。使用描述性统计方法分析患者特征、LOS、并发症、再次手术和翻修的数据。安全性和可行性定义为 90 天内的并发症和再次手术率与非快速通道外侧 UKA 或快速通道内侧 UKA 相当。

结果

我们纳入了 170 例患者,平均年龄为 66(SD 12)岁。中位 LOS 为 1 天(四分位距 1-1),与 2012-2018 年相比无变化。18%的患者在手术当天出院。90 天内,7 例患者出现医疗并发症,5 例患者出现手术并发症。3 例患者接受了再次手术,2 例为软组织翻修,第三例因髌骨卡压切除骨赘。1 例因轴承脱位而进行了翻修。

结论

我们的研究结果表明,快速通道方案下的外侧 UKA 是可行且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8107/10305836/7c9d6f5f3b7f/ActaO-94-13653-g001.jpg

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