■虽然单室膝关节置换术(UKA)和截骨术通常用于治疗膝关节骨关节炎,不同手术间并发症情况的差异仍然知之甚少.
■本研究的目的是通过使用美国骨科委员会(ABOS)第二部分口腔检查病例列表数据库,评估新培训的外科医生中UKA和关节周围截骨术治疗膝骨关节炎的趋势和并发症发生率。据推测,更多的成人重建研究员培训的外科医生将执行UKA,而更多的运动医学奖学金训练的外科医生将进行截骨,这两种手术的并发症发生率都很低。
■横断面研究;证据水平,3.
■在ABOS数据库中查询了接受UKA的患者,胫骨高位截骨,2011年至2021年检查年度的股骨远端截骨手术。患者特征,外科医生奖学金培训历史,外科医生报告的术后并发症,记录再入院率和再手术率。使用独立t检验和卡方检验对UKA和截骨组进行比较。
■UKA组2524例,截骨组270例。执行UKA的大多数新培训的外科医生(70.5%)接受了成人重建方面的研究金培训,而大多数进行截骨术的人(57.8%)接受了运动医学研究金训练(P<.001)。在研究期间,UKA和截骨术的发生率增加(2011年每10,000例进行18.8UKAs和1.8截骨术,而2021年每10,000例进行39.5UKAs和4.2截骨术)。与UKA相比,截骨术的麻醉并发症发生率明显更高(2.2%vs0.6%;P=0.015),手术并发症(23.7%vs7.3%;P<.001),再次手术(5.2%对1.9%;P=0.002),和感染(6.7%vs1.4%;P<.001)。医疗并发症的发生率没有显着差异,重新接纳,深静脉血栓形成,肺栓塞,或僵硬/关节纤维化。
■在接受ABOS第二部分口腔检查的新培训的外科医生中,在过去的十年中,UKA和膝关节周围截骨术的发生率有所增加。与UKA相比,截骨术后并发症发生率较高,手术并发症的总发生率为23.7%。
UNASSIGNED: While unicompartmental knee arthroplasty (UKA) and osteotomy procedures are commonly used to treat knee osteoarthritis, the differences in complication profiles between procedures are still poorly understood.
UNASSIGNED: The purpose of this study was to assess the trends and complication rates of UKA and periarticular knee osteotomy for knee osteoarthritis among newly trained surgeons by using the American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination Case List database. It was hypothesized that more adult reconstruction fellowship-trained surgeons would perform UKA, while more sports medicine fellowship-trained surgeons would perform osteotomy, and that both procedures would have low rates of complications.
UNASSIGNED: Cross-sectional study; Level of evidence, 3.
UNASSIGNED: The ABOS database was queried for patients who underwent UKA, high tibial osteotomy, and distal femoral osteotomy procedures in examination years 2011 to 2021. Patient characteristics, surgeon fellowship training history, surgeon-reported postoperative complications, and readmission and reoperation rates were recorded. Comparisons between the UKA and osteotomy groups were performed using independent t tests and chi-square tests.
UNASSIGNED: There were 2524 patients in the UKA group and 270 patients in the osteotomy group. The majority of newly trained surgeons performing UKA (70.5%) had fellowship training in adult reconstruction, while the majority of those performing osteotomy (57.8%) had fellowship training in sports medicine (P < .001). The incidence of UKA and osteotomy increased during the study period (18.8 UKAs and 1.8 osteotomies performed per 10,000 cases in 2011 vs 39.5 UKAs and 4.2 osteotomies performed per 10,000 cases in 2021). Rates were significantly higher for osteotomy compared with UKA regarding anesthetic complications (2.2% vs 0.6%; P = .015), surgical complications (23.7% vs 7.3%; P < .001), reoperation (5.2% vs 1.9%; P = .002), and infection (6.7% vs 1.4%; P < .001). There were no significant differences in rates of medical complication, readmission, deep vein thrombosis, pulmonary embolism, or stiffness/arthrofibrosis.
UNASSIGNED: Among newly trained surgeons taking the ABOS Part II Oral Examination, the incidence of UKA and periarticular knee osteotomy increased over the past decade. Compared with UKA, complication rates were higher after osteotomy, with an overall surgical complication rate of 23.7%.