Department of Neurosurgery, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan, R.O.C.
In Vivo. 2024 Nov-Dec;38(6):2981-2989. doi: 10.21873/invivo.13781.
BACKGROUND/AIM: Gout, characterized by acute inflammatory symptoms and monosodium urate crystal deposits in joints, is prevalent among males and the elderly. Total knee arthroplasty (TKA) is a common treatment for knee osteoarthritis (OA), but its impact on the risk of developing gout is unclear. This study examined the risk of gout in patients undergoing TKA.
Utilizing the TriNetX research network, a retrospective cohort study was conducted on OA patients without prior gout. The TKA cohort was compared to a non-TKA control group using propensity score matching to balance covariates. The primary outcome was the incidence of gout over a five-year follow-up period.
The study included 38,834 matched pairs of TKA and non-TKA patients. TKA patients had a 15.6% higher risk of developing gout (HR=1.156; 95%CI=1.042-1.284) compared to controls. Sensitivity analyses confirmed the increased risk across various models and follow-up durations.
TKA is associated with a higher risk of developing gout, particularly in females and older adults. Clinicians should monitor and manage gout risk in TKA patients, emphasizing preventive measures and early intervention. Further research is needed to understand the underlying mechanisms and improve patient care post-TKA.
背景/目的：痛风以关节急性炎症症状和单钠尿酸盐晶体沉积为特征，多发于男性和老年人。全膝关节置换术（TKA）是治疗膝关节骨关节炎（OA）的常用方法，但它对痛风发病风险的影响尚不清楚。本研究旨在探讨 TKA 患者发生痛风的风险。
利用 TriNetX 研究网络，对既往无痛风的 OA 患者进行了一项回顾性队列研究。采用倾向评分匹配法对 TKA 队列和非 TKA 对照组进行比较，以平衡协变量。主要结局是五年随访期间痛风的发病率。
本研究纳入了 38834 对 TKA 和非 TKA 患者的匹配对。与对照组相比，TKA 患者发生痛风的风险增加了 15.6%（HR=1.156；95%CI=1.042-1.284）。敏感性分析证实了在各种模型和随访时间内均存在这种风险增加。
TKA 与痛风发病风险增加相关，尤其是在女性和老年人群中。临床医生应在 TKA 患者中监测和管理痛风风险，强调预防措施和早期干预。需要进一步研究以了解潜在机制并改善 TKA 后患者的护理。
