背景:患有Paget病的患者比对照组更频繁地需要全髋关节置换术(THA)和全膝关节置换术(TKA)。然而,关于他们的结果仍然存在争议。我们旨在评估有关Paget病患者THA和TKA后结局的文献。
方法:MEDLINE,在EMBASE和Cochrane数据库中搜索所有评价Paget病患者THA/TKA后转归的文章。使用纽卡斯尔-渥太华量表评估纳入研究的质量。
结果:共包括19篇文章(在1976年至2022年之间发表),包括58,695名患者(48,766名对照和10,018名患有佩吉特病的患者),从209个潜在相关的标题。患者平均7.8年的合并死亡率为32.5%(范围,0.1到20)在THA和31.0%之后,平均8.5年(范围,2至20)跟随TKA,7.2年的合并修订率为4.4%(范围,0到20)在THA之后,在7.4年内为2.2%(范围,2至20)遵循TKA。肾脏和呼吸系统并发症,以及异位骨化和手术部位感染是最常见的术后并发症。
结论:评估佩吉特病患者关节成形术的研究结果报告存在主要异质性,低到中等质量的研究。这些接受THA和TKA的患者似乎与未受影响的患者具有相似的植入物寿命。然而,他们出现内科和外科并发症的风险增加,并且可能因手术而死亡的风险更高。
Patients who have Paget\'s Disease more frequently require total hip arthroplasty (THA) and total knee arthroplasty (TKA) than matched controls. However, controversy remains regarding their outcome. We aimed to evaluate the literature regarding outcomes following THA and TKA in patients who have Paget\'s Disease.
MEDLINE, EMBASE and Cochrane databases were searched for all articles evaluating outcomes following THA and TKA in patients who have Paget\'s Disease. Quality of included studies was assessed using the Newcastle-Ottawa Scale.
A total of 19 articles (published between 1976 and 2022) were included, comprising 58,695 patients (48,766 controls and 10,018 patients who have Pagets Disease), from 209 potentially relevant titles. Patients with Paget\'s Disease have a pooled mortality of 32.5% at a mean of 7.8 years (range, 0.1 to 20) following THA and 31.0% at a mean of 8.5 years (range, 2 to 20) following TKA, with a pooled revision rate of 4.4% at 7.2 years (range, 0 to 20) following THA and 2.2% at 7.4 years (range, 2 to 20) following TKA. Renal and respiratory complications, as well as heterotopic ossification and surgical-site infection were the most common post-operative complications.
There is marked heterogeneity in outcome reporting of studies assessing arthroplasty in patients who have Paget\'s Disease, with studies of low to moderate quality. Patients with Paget\'s Disease undergoing THA and TKA appear to have similar implant longevity as their unaffected counterparts. However, they appear to have an increased risk of medical and surgical complications and may have a higher mortality risk from their procedure.