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WCO-IOF-ESCEO 2016:全膝关节置换术后10年患者髋部骨折风险增加

2016-04-17 MedSci MedSci原创

WCO-IOF-ESCEO 2016:全膝关节置换术后10年患者髋部骨折的风险增加来自瑞典默恩达尔萨尔格学院的一项新的研究显示,全膝关节置换后10年髋关节骨折的风险增加,该研究结果是基于对1987-2002年覆盖整个瑞典人口的数据分析所得,所纳入的研究对象出生于1902-1952年间。研究结果表明,由于原发性骨关节炎而接受全膝关节置换(TKR)的患者手术前10年髋部和脊椎骨折的风险很低。但是,与未

来自瑞典默恩达尔萨尔格学院的一项新的研究显示,全膝关节置换后10年髋关节骨折的风险增加,该研究结果是基于对1987-2002年覆盖整个瑞典人口的数据分析所得,所纳入的研究对象出生于1902-1952年间。

研究结果表明,由于原发性骨关节炎而接受全膝关节置换(TKR)的患者手术前10年髋部和脊椎骨折的风险很低。但是,与未接受TKR的普通人群相比,接受手术治疗的患者髋部骨折的风险增加了4%,椎骨骨折的风险增加了19%。

研究中,共有3221名患者接受了全膝关节置换并发生了髋部骨折。膝关节骨性关节炎患者接受TKR前10年髋关节骨折的危险比为0.58,接受TKR后10年危险比1.04;椎骨骨折的危险比则分别为0.55和1.19。校正年龄、性别、历年和出生地后,仍可发现患者术前髋部或脊椎骨折的风险较低,而术后髋部或脊椎骨折的风险增加。TKR后第一年患者死亡的危险比为0.40,TKR治疗10年后则为1.06。

该研究第一作者C. H. Vala说道,“这个研究表明骨关节炎与更高的骨量有关,而且患者有可能因为疼痛导致其体力活动水平下降。膝关节置换后的10年患者髋部和脊椎骨折的风险增加可能是因为疼痛,康复导致的身体活动增加和其他生物力学因素所致。在瑞典,每年约有1.3万人进行全膝关节置换,因此很有必要行进一步的研究以探究该人群骨折风险增加的原因。”

原始出处:

Study shows hip fracture risk rises in the 10 years after total knee replacement. EurekAlert! 16-APR-2016.

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    2016-09-01 ylzr123

    好文,值得学习,赞!

    0

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    2016-12-01 yxch48
  4. 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time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1548382, encodeId=54431548382fc, content=<a href='/topic/show?id=39bf2964295' target=_blank style='color:#2F92EE;'>#全膝关节置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29642, encryptionId=39bf2964295, topicName=全膝关节置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e4014073525, createdName=12498f6em11暂无昵称, createdTime=Tue Apr 19 11:29:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576527, encodeId=85a415e6527fa, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, 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  5. 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  6. 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  7. 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time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1548382, encodeId=54431548382fc, content=<a href='/topic/show?id=39bf2964295' target=_blank style='color:#2F92EE;'>#全膝关节置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29642, encryptionId=39bf2964295, topicName=全膝关节置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e4014073525, createdName=12498f6em11暂无昵称, createdTime=Tue Apr 19 11:29:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576527, encodeId=85a415e6527fa, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Apr 19 11:29:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79530, encodeId=1c6de95300e, content=医学进步会解决这些问题, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Tue Apr 19 09:17:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-04-19 liuquan
  8. 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  9. 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    2016-04-19 xiaotaiyang1

    医学进步会解决这些问题

    0

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  2013年美国骨科医师学会年会(AAOS)于3月19-23日在美国隆重召开。   肥胖症是美国的一个现实问题。据最近全国数据显示,2009-2010年间,超过1/3的美国成人属于肥胖。由于肥胖症患病率持续上升,所以骨科医生在较年轻、较肥胖的患者中实施了更多的全膝关节置换术(TKA)。   来自明尼苏达州罗切斯特的梅奥医学中心的Hilal Maradit-Kremers医学博士研究

BMJ:不典型双侧膝关节骨关节炎-案例报道

患者女,64岁,因“间歇性的双侧膝关节疼痛数年”就诊。疼痛呈轻度、弥漫性疼痛,步行时疼痛可患者也可恶化,偶尔会有不稳定的感觉。患者否认外伤史、机械性的症状如锁定、日常活动受到影响、或其他关节疼痛病史。不过患者有膝骨关节炎和骨质疏松症。几年前患者左膝盖注射过皮质激素,但从未接受过膝盖的影像学检查。近期患者因疼痛一直在使用对乙酰氨基酚(扑热息痛)和萘普生。查体示患者双侧膝外翻,关节线和髌面有双侧弥漫性

NEJM:全膝关节置换术的安全性研究

美国每年进行超过670000例的全膝关节置换手术;然而,与非手术干预相比,支持手术的有效性高质量的证据是缺乏的。在这项随机,对照临床试验中,研究人员招募了100例中度至重度膝关节骨性关节炎并符合单侧全膝关节置换术条件的患者。患者被随机分配接受全膝关节置换术,随后12周的非手术治疗(全膝关节置换组)或只接受12周的非手术治疗(非手术治疗组),这由物理治疗师和营养师完成,由运动,教育,饮食指导,鞋垫使

Arthritis Rheum:类风湿关节炎患者 THA后易脱臼,TKA后易感染

  加拿大一项研究显示,与骨性关节炎(OA)患者相比,类风湿关节炎(RA)患者行全髋关节置换术(THA)后发生脱臼和行全膝关节置换术(TKA)后感染风险较高。论文发表于《关节炎与风湿病》[Arthritis Rheum 2012,64(12):3839]杂志。   研究者检索Medline等数据库,选取1990~2011年间发表的RA、OA患者(≥200个关节)行TKA、TH

AAOS 2013:全膝关节置换术(TKA)术后工作恢复率达99%

  来自2013年AAOS年会上的一项报告显示,全膝关节置换术(TKA)是一种非常成功的手术,能使98%的患者术后恢复工作。该研究共同作者Ryan M. Nunley博士指出,89%的患者可回到先前的工作岗位。那些从事久坐职业的患者恢复到日常工作比率最高,甚至那些从事重体力工作的患者能恢复到之前他们同样工作时间的88%。   该多中心研究是通过一个独立的、第三方调查中心完成,

JBJS:固定与旋转平台全膝置换中期疗效相当

尽管固定平台(Fixed-Bearing, FB)全膝关节置换术后临床成功率高,无论是年轻还是老年患者术后10-15年时假体生存率均可高达90%-98%,然而与这种类型的假体相关的聚乙烯衬垫磨损和骨溶解会导致的假体松动及失败,由此研究者设计了旋转平台(Mobile-Bearing, MB)式假体以试图解决这些问题。 MB设计在理论上相对于FB设计有一定的优势,包括具有自动调节以适应和复制更接

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