PDF(Pubmed)
Abstract：
UNASSIGNED: Although extensor mechanism failure following total knee arthroplasty (TKA) is a devastating complication and has been heavily studied in the literature, the impact of extensor mechanism rupture and concomitant repair prior to TKA has not previously been evaluated. The purpose of this investigation was to evaluate how quadriceps and/or patellar tendon repairs prior to TKA would impact medical and surgery-related complications following TKA.
UNASSIGNED: The PearlDiver database was retrospectively reviewed to identify all primary TKA patients from 2010 to 2019. Patients who underwent quadriceps or patellar tendon repair prior to TKA were matched using a propensity score algorithm to a control cohort. We compared medical and surgical complication rates, emergency room visits, readmissions, and 90-day cost of care between the groups.
UNASSIGNED: A total of 1197 patients underwent extensor mechanism repair prior to TKA and were matched to 11,970 patients who did not undergo repair prior to TKA. Patients who underwent extensor mechanism repair had higher rates of 90-day medical complications, as well as 1-year surgery-related complications including revision TKA (odds ratio [OR] 6.06; P < .001), lysis of adhesions (OR 2.18; P = .026), aseptic loosening (OR 2.21; P = .018), infection (OR 7.58; P < .001), and fracture (OR 8.53; P < .001). Patients with prior extensor mechanism repair were more likely to return to the emergency department (OR 1.66; P < .001) and become readmitted (OR 4.15; P < .001) within 90 days.
UNASSIGNED: Patients with previous extensor mechanism repair exhibited higher medical and surgery-related complications, including lysis of adhesions, following TKA than a control cohort. These findings may suggest that patients may require additional surveillance in the early postoperative period to avoid these disastrous complications following primary TKA.
UNASSIGNED: The PearlDiver database was retrospectively reviewed to identify all primary TKA patients from 2010 to 2019. Patients who underwent quadriceps or patellar tendon repair prior to TKA were matched using a propensity score algorithm to a control cohort. We compared medical and surgical complication rates, emergency room visits, readmissions, and 90-day cost of care between the groups.
UNASSIGNED: A total of 1197 patients underwent extensor mechanism repair prior to TKA and were matched to 11,970 patients who did not undergo repair prior to TKA. Patients who underwent extensor mechanism repair had higher rates of 90-day medical complications, as well as 1-year surgery-related complications including revision TKA (odds ratio [OR] 6.06; P < .001), lysis of adhesions (OR 2.18; P = .026), aseptic loosening (OR 2.21; P = .018), infection (OR 7.58; P < .001), and fracture (OR 8.53; P < .001). Patients with prior extensor mechanism repair were more likely to return to the emergency department (OR 1.66; P < .001) and become readmitted (OR 4.15; P < .001) within 90 days.
UNASSIGNED: Patients with previous extensor mechanism repair exhibited higher medical and surgery-related complications, including lysis of adhesions, following TKA than a control cohort. These findings may suggest that patients may require additional surveillance in the early postoperative period to avoid these disastrous complications following primary TKA.
摘要：
■尽管全膝关节置换术（TKA）后的伸肌机制衰竭是一种毁灭性的并发症，并且已经在文献中进行了大量研究，在TKA之前,尚未评估伸肌机制断裂和伴随修复的影响.这项研究的目的是评估TKA之前的股四头肌和/或髌腱修复如何影响TKA之后的医疗和手术相关并发症。
■回顾性审查了PearlDiver数据库，以确定2010年至2019年的所有原发性TKA患者。在TKA之前接受股四头肌或髌腱修复的患者使用倾向评分算法与对照组进行匹配。我们比较了内科和外科并发症的发生率，急诊室探视,再入院,以及组间90天的护理费用。
■共有1197例患者在TKA之前接受了伸肌机制修复，与11970例在TKA之前没有接受修复的患者相匹配。接受伸肌机制修复的患者90天的医疗并发症发生率更高，以及1年手术相关并发症，包括翻修TKA（比值比[OR]6.06;P<.001），粘连溶解（OR2.18；P=0.026），无菌性松动（OR2.21；P=.018），感染（OR7.58；P<.001），断裂(OR8.53;P<.001)。既往有伸肌机制修复的患者更有可能在90天内返回急诊科（OR1.66;P<.001）并再次入院（OR4.15;P<.001）。
■先前有伸肌机制修复的患者表现出更高的医疗和手术相关并发症，包括粘连的溶解，TKA后比对照组队列。这些发现可能表明，患者可能需要在术后早期进行额外的监测，以避免初次TKA后的这些灾难性并发症。
■回顾性审查了PearlDiver数据库，以确定2010年至2019年的所有原发性TKA患者。在TKA之前接受股四头肌或髌腱修复的患者使用倾向评分算法与对照组进行匹配。我们比较了内科和外科并发症的发生率，急诊室探视,再入院,以及组间90天的护理费用。
■共有1197例患者在TKA之前接受了伸肌机制修复，与11970例在TKA之前没有接受修复的患者相匹配。接受伸肌机制修复的患者90天的医疗并发症发生率更高，以及1年手术相关并发症，包括翻修TKA（比值比[OR]6.06;P<.001），粘连溶解（OR2.18；P=0.026），无菌性松动（OR2.21；P=.018），感染（OR7.58；P<.001），断裂(OR8.53;P<.001)。既往有伸肌机制修复的患者更有可能在90天内返回急诊科（OR1.66;P<.001）并再次入院（OR4.15;P<.001）。
■先前有伸肌机制修复的患者表现出更高的医疗和手术相关并发症，包括粘连的溶解，TKA后比对照组队列。这些发现可能表明，患者可能需要在术后早期进行额外的监测，以避免初次TKA后的这些灾难性并发症。
