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软组织放射学膝关节指数在预测全膝关节置换术后浅表手术部位感染方面的可靠性如何?

How reliable is the soft tissue radiological knee index in predicting superficial surgical site infection following total knee arthroplasty?

机构信息

Department of Orthopaedic Surgery, HELIOS ENDO-Clinic Hamburg, Holstenstraße 2, 22767, Hamburg, Germany.

出版信息

Arch Orthop Trauma Surg. 2024 Dec;144(12):5191-5198. doi: 10.1007/s00402-024-05346-x. Epub 2024 May 2.

DOI:10.1007/s00402-024-05346-x
PMID:38693290
Abstract

INTRODUCTION

The purpose of this study was to evaluate the association between the Soft Tissue Radiological Knee (SToRK) Index and the risk of developing a superficial surgical site infection (SSSI) following primary total knee arthroplasty (TKA).

METHODS

The SToRK Index was measured using calibrated long leg radiographs (LLR) in 174 patients undergoing TKA.

RESULTS

A moderate correlation was found between the SToRK Index and body mass index (BMI) (r=0.574; p < 0.001). The SToRK Index was a better predictor of SSSI in females than males. In females, a SToRK Index cutoff of 2.01 had a sensitivity and specificity of 41.3% and 74.6% for developing SSSI, respectively, with a positive likelihood ratio of 1.63.

CONCLUSION

The SToRK Index can be used as an additional tool in assessing the risk for SSSI after TKA. It might be more predictive in females due to the different fat distribution compared to males.

摘要

简介

本研究旨在评估软组织放射学膝关节(SToRK)指数与初次全膝关节置换术后发生浅表手术部位感染(SSSI)的风险之间的关联。

方法

在 174 例行 TKA 的患者中,使用校准的长腿 X 线片(LLR)测量 SToRK 指数。

结果

SToRK 指数与体重指数(BMI)之间存在中度相关性(r=0.574;p<0.001)。SToRK 指数在女性中比男性更能预测 SSSI。在女性中,SToRK 指数截点为 2.01 时,对 SSSI 的敏感性和特异性分别为 41.3%和 74.6%,阳性似然比为 1.63。

结论

SToRK 指数可作为评估 TKA 后 SSSI 风险的附加工具。与男性相比,由于女性的脂肪分布不同,该指数在女性中的预测性可能更高。

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本文引用的文献

1
Patient-related factors associated with superficial surgical site infection and progression to a periprosthetic joint infection after elective primary total joint arthroplasty: a single-centre, retrospective study in Sweden.患者相关因素与择期初次全关节置换术后浅表手术部位感染和进展为假体周围关节感染的相关性:瑞典单中心回顾性研究。
BMJ Open. 2022 Sep 19;12(9):e060754. doi: 10.1136/bmjopen-2022-060754.
2
Risk factors associated with surgical site infections following joint replacement surgery: a narrative review.关节置换术后手术部位感染的相关危险因素:一项叙述性综述
Arthroplasty. 2022 May 1;4(1):11. doi: 10.1186/s42836-022-00113-y.
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Lower Extremity Girth Does Not Predict Complications in TKA.
下肢周径与 TKA 并发症无关。
J Arthroplasty. 2021 Aug;36(8):2765-2770. doi: 10.1016/j.arth.2021.03.039. Epub 2021 Mar 27.
4
Soft Tissue Radiological Knee (SToRK) Index: An observational cohort study to produce an index that quantifies the magnitude of soft tissue around the knee using standard radiographs.膝关节软组织放射学(SToRK)指数:一项观察性队列研究,旨在制定一个利用标准X光片量化膝关节周围软组织大小的指数。
J Clin Orthop Trauma. 2020 Oct;11(Suppl 5):S909-S915. doi: 10.1016/j.jcot.2020.08.001. Epub 2020 Aug 18.
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Relationship between body mass index and the risk of periprosthetic joint infection after primary total hip arthroplasty and total knee arthroplasty.初次全髋关节置换术和全膝关节置换术后体重指数与假体周围关节感染风险的关系。
Ann Transl Med. 2020 Apr;8(7):464. doi: 10.21037/atm.2020.03.112.
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Greater Knee Soft Tissue Thickness Predisposes Patients to Subsequent Periprosthetic Joint Infection After Total Knee Arthroplasty.全膝关节置换术后,更大的膝关节软组织厚度使患者易发生假体周围关节感染。
J Arthroplasty. 2020 Jul;35(7):1924-1927. doi: 10.1016/j.arth.2020.02.049. Epub 2020 Feb 29.
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Clinical Faceoff: Should Orthopaedic Surgeons Have Strict BMI Cutoffs for Performing Primary TKA and THA?临床对峙:骨科医生在进行初次全膝关节置换术(TKA)和全髋关节置换术(THA)时是否应该有严格的体重指数(BMI)临界值?
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