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在阿卜杜勒阿齐兹国王医疗城,对全髋关节和膝关节置换术后假体关节感染的患者相关危险因素进行了一项 10 年回顾性研究。

Patient-related risk factors of prosthetic joint infections following total hip and knee arthroplasty at King Abdulaziz Medical City, a 10-year retrospective study.

机构信息

Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.

King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

出版信息

J Orthop Surg Res. 2023 Sep 22;18(1):717. doi: 10.1186/s13018-023-04210-9.

DOI:10.1186/s13018-023-04210-9
PMID:37736732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10514936/
Abstract

BACKGROUND

Total joint arthroplasty (TJA) can be associated with the development of periprosthetic joint infection (PJI). It is necessary to determine the modifiable and non-modifiable risk factors of PJI to provide optimum healthcare to TJA candidates.

METHODS

This single-center retrospective review investigated 1198 patients who underwent TJA from 2012 to 2022. The data analysis comprised two stages. The first stage was a descriptive analysis, while the second stage was a bivariate analysis. The sociodemographic data, medical history, operative details, and presence of PJI postoperatively were evaluated.

RESULTS

The study sample consisted of 1198 patients who underwent TJA. The mean patient age was 63 years. Among the patients, only 1.3% had PJI. No comorbidity was significantly related to PJI. General anesthesia was used in almost 21% of the patients and was significantly associated with a higher risk of infection (p = 0.049). An increased operative time was also significantly related to PJI (p = 0.012). Conversely, tranexamic acid (TXA) administration was a protective factor against PJI (p = 0.017).

CONCLUSION

Although PJI is not a common complication of TJA, multiple risk factors such as general anesthesia and prolonged operative time play a significant role in its development. In contrast, TXA administration is thought to reduce the risk of PJI effectively.

摘要

背景

全关节置换术(TJA)可能会导致假体周围关节感染(PJI)。确定 PJI 的可改变和不可改变的危险因素对于为 TJA 候选者提供最佳医疗保健至关重要。

方法

本单中心回顾性研究调查了 2012 年至 2022 年间接受 TJA 的 1198 名患者。数据分析分为两个阶段。第一阶段是描述性分析,第二阶段是双变量分析。评估了社会人口统计学数据、病史、手术细节以及术后是否存在 PJI。

结果

本研究样本包括 1198 名接受 TJA 的患者。患者的平均年龄为 63 岁。在这些患者中,只有 1.3%患有 PJI。没有合并症与 PJI 显著相关。近 21%的患者接受全身麻醉,与感染风险显著增加相关(p=0.049)。手术时间延长也与 PJI 显著相关(p=0.012)。相反,氨甲环酸(TXA)的使用是预防 PJI 的保护因素(p=0.017)。

结论

尽管 PJI 不是 TJA 的常见并发症,但全身麻醉和手术时间延长等多种危险因素在其发展中起着重要作用。相比之下,TXA 的使用被认为可以有效降低 PJI 的风险。

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Bone Joint J. 2022 Sep;104-B(9):1060-1066. doi: 10.1302/0301-620X.104B9.BJJ-2022-0116.R1.
2
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Iowa Orthop J. 2022 Jun;42(1):155-161.
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Tourniquet use in total knee arthroplasty and the risk of infection: a meta-analysis of randomised controlled trials.全膝关节置换术中使用止血带与感染风险:一项随机对照试验的荟萃分析
J Exp Orthop. 2022 Jul 1;9(1):62. doi: 10.1186/s40634-022-00485-9.
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BMC Musculoskelet Disord. 2021 Sep 12;22(1):776. doi: 10.1186/s12891-021-04647-1.
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