双侧与单侧全膝关节置换术的比较结果：大数据分析
Comparative Outcomes of Bilateral Versus Unilateral Total Knee Arthroplasty: A Big Data Analysis.
作者信息
Maman David, Dumov Daniel, Nandakumar Maneesh, Litmanowicz Batia, Shpigelman Daniel, Fournier Linor, Steinfeld Yaniv, Yonai Yaniv, Berkovich Yaron
机构信息
Carmel Medical Center, Haifa 3436212, Israel.
Faculty of Medicine, Technion Israel Institute of Technology, Haifa 2611001, Israel.
出版信息
Healthcare (Basel). 2025 Apr 30;13(9):1033. doi: 10.3390/healthcare13091033.
Bilateral total knee arthroplasty (B-TKA) is a surgical option for patients with bilateral osteoarthritis, offering potential efficiency and cost advantages but with increased perioperative risk. We conducted a retrospective analysis of 2,299,979 elective TKA cases from the Nationwide Inpatient Sample (2016-2019). Propensity score matching (PSM) was used to compare 83,980 B-TKA patients with matched unilateral TKA (U-TKA) patients. Outcomes included in-hospital mortality, complications, length of stay, and hospital charges. B-TKA patients had higher rates of complications such as deep vein thrombosis (OR 1.798) and pulmonary embolism (OR 1.883), longer hospital stays (3.03 vs. 2.49 days), and higher charges (USD 83,639 vs. USD 59,215; all < 0.001). Although B-TKA is associated with increased perioperative risk, it may offer logistical and economic advantages in well-selected patients. These findings support the need for risk stratification in surgical decision-making.
双侧全膝关节置换术（B-TKA）是双侧骨关节炎患者的一种手术选择，具有潜在的效率和成本优势，但围手术期风险增加。我们对全国住院患者样本（2016 - 2019年）中的2,299,979例择期全膝关节置换术病例进行了回顾性分析。采用倾向评分匹配（PSM）方法，将83,980例B-TKA患者与匹配的单侧全膝关节置换术（U-TKA）患者进行比较。观察指标包括住院死亡率、并发症、住院时间和住院费用。B-TKA患者发生深静脉血栓形成（OR 1.798）和肺栓塞（OR 1.883）等并发症的发生率更高，住院时间更长（3.03天对2.49天），费用更高（83,639美元对59,215美元；均P < 0.001）。尽管B-TKA与围手术期风险增加相关，但在精心挑选的患者中可能具有后勤和经济优势。这些发现支持在手术决策中进行风险分层的必要性。
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