Dubin Jeremy A, Bains Sandeep S, Paulson Ambika E, Monarrez Ruben, Hameed Daniel, Nace James, Mont Michael, Delanois Ronald E
Lifebridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland.
School of Medicine, Georgetown University, Washington, District of Columbia.
J Arthroplasty. 2024 Mar;39(3):760-765. doi: 10.1016/j.arth.2023.09.013. Epub 2023 Sep 16.
The number of revision total knee arthroplasties (TKAs) is projected to reach 268,200 cases annually by 2030 in the United States. The growing demand for revision TKA can be attributed to the successes of primary TKAs combined with an aging population, patient desires to remain active, as well as expanded indications for younger patients. Given the evolving nature of revision TKAs, an epidemiological analysis of: (1) etiologies; (2) demographics, including age and region; as well as (3) lengths of stay (LOS) offers a way to minimize the gap between appropriate understanding and effective intervention.
From 2016 to 2022, a national, all-payer database was queried. Incidences and indications were analyzed for a total of 135,983 patients who had revision TKA procedures.
The most common etiologies for revision TKA procedures were infection (19.3%) and aseptic loosening (12.8%), followed by mechanical complications (7.9%). The largest age group was 65 to 74 years (34.9%) followed by 55 to 64 years (32.2%), then age >75 years (20.5%). The South had the largest total procedure cohort (39.8%), followed by the Midwest (28.6%), then the Northeast (18.6%), and the West (13.0%). The mean length of stay was 3.86 days (range, 1.0 to 15.0).
Our study details the current status of revision TKA through 2022. While infection and aseptic loosening remain leading causes, we found a low aseptic loosening rate of 12.8%.
预计到2030年，美国每年翻修全膝关节置换术（TKA）的病例数将达到268,200例。翻修TKA需求的不断增长可归因于初次TKA的成功、人口老龄化、患者保持活跃的愿望以及年轻患者适应证的扩大。鉴于翻修TKA的不断发展，对以下方面进行流行病学分析：（1）病因；（2）人口统计学特征，包括年龄和地区；以及（3）住院时间（LOS），提供了一种缩小适当理解与有效干预之间差距的方法。
查询了2016年至2022年的全国全付费者数据库。对总共135,983例行翻修TKA手术的患者的发病率和适应证进行了分析。
翻修TKA手术最常见的病因是感染（19.3%）和无菌性松动（12.8%），其次是机械并发症（7.9%）。最大的年龄组是65至74岁（34.9%），其次是55至64岁（32.2%），然后是年龄>75岁（20.5%）。南部的手术队列总数最多（39.8%），其次是中西部（28.6%），然后是东北部（18.6%）和西部（13.0%）。平均住院时间为3.86天（范围为1.0至15.0天）。
我们的研究详细阐述了截至2022年翻修TKA的现状。虽然感染和无菌性松动仍然是主要原因，但我们发现无菌性松动率较低，为12.8%。
