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Lymphedema microsurgery reduces the rate of implant removal for patients who have pre-existing lymphedema and total knee arthroplasty for knee osteoarthritis.

淋巴水肿显微手术降低了先前存在淋巴水肿和全膝关节置换术治疗膝关节骨关节炎患者的植入物取出率。

  • 影响因子:2.88
  • DOI:10.1002/jso.25517
  • 作者列表:"Voravitvet TY","Chen C","Lin CY","Cheng MH
  • 发表时间:2020-01-01
Abstract

INTRODUCTION:Patients with pre-existing lymphedema who undergo total knee arthroplasty (TKA) for osteoarthritis (OA) are at high risk for periprosthetic joint infection. This complication usually requires removal of the implant. This study aimed to investigate whether surgical treatment of lymphedema reduces the rate of prosthesis removal in such patients. MATERIALS AND METHODS:We retrospectively reviewed our prospective database of patient information collected between January 2009 and December 2018. A total of 348 cases of lower extremity lymphedema were reviewed, and those who underwent total knee TKA for OA of the knee were included. Patient demographics, clinical data, lymphedema surgical history, and TKA surgical history including any episodes of removal were collected and analyzed. RESULTS:There were nine of 15 lymphedema patients with knee OA who subsequently underwent TKA. The mean patient age was 70.4 ± 7.1 years. A total of 18 TKAs were performed in nine patients. The knee prosthesis removal rate was 66.7% (12/18). The prosthesis removal rate was 40% (2/5) in patients who underwent lymphedema microsurgery vs 76.9% (10/13) for those who did not (P = .03). CONCLUSIONS:Pre-existing lymphedema is associated with a high rate of knee prosthesis removal. Lymphedema microsurgery reduced the removal rate of knee prostheses. We recommend that lymphedema microsurgery be considered for patients who require TKA as a treatment for of the knee.

摘要

导读: 因骨关节炎 (OA) 而接受全膝关节置换术 (TKA) 的淋巴水肿患者存在假体周围感染的高风险。这种并发症通常需要移除植入物。本研究旨在探讨手术治疗淋巴水肿是否会降低此类患者假体取出率。 材料和方法: 我们回顾性回顾了我们在 2009 年 1 月至 2018 年 12 月期间收集的患者信息的前瞻性数据库。共回顾 348 例下肢淋巴水肿病例,纳入因膝关节OA行全膝关节TKA者。收集并分析患者人口统计学、临床数据、淋巴水肿手术史和TKA手术史 (包括任何切除发作)。 结果: 15 例膝关节OA淋巴水肿患者中有 9 例随后接受了TKA。患者平均年龄 70.4 ± 7.1 岁。9 例患者共进行了 18 例TKAs。膝关节假体清除率为 66.7% (12/18)。淋巴水肿显微手术患者的假体取出率为 40% (2/5),而非淋巴水肿显微手术患者的假体取出率为 76.9% (10/13) (p =.03)。 结论: 预先存在的淋巴水肿与膝关节假体取出率高有关。淋巴水肿显微手术降低了膝关节假体的切除率。我们建议对需要TKA治疗膝关节的患者考虑行淋巴水肿显微手术。

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DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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关节疾病方向

各类骨关节疾病,包括退行性关节炎、滑囊炎、滑膜炎、颈椎病、腰椎病、肩周炎、骨质增生、风湿性关节炎、类风湿性关节炎、股骨头坏死等。

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