切换至 "中华医学电子期刊资源库"

中华老年骨科与康复电子杂志 ›› 2025, Vol. 11 ›› Issue (01) : 4 -13. doi: 10.3877/cma.j.issn.2096-0263.2025.01.002

关节置换

美国住院患者膝关节翻修术后肺部并发症发病率及危险因素分析
包良笑1, 刘兆锋1, 谢豪1, 杨钦烽1, 史占军1,()   
  1. 1. 510515 广州,南方医科大学南方医院关节与骨病外科
  • 收稿日期:2023-11-16 出版日期:2025-02-05
  • 通信作者: 史占军
  • 基金资助:
    南方医科大学2021年度高等教育教学改革项目(202131)融合课程思政的临床护理混合式教学实践改革

Incidence and risk factors of pulmonary complications after revision knee arthroplasty based on USA National Inpatient Sample

Liangxiao Bao1, Zhaofeng Liu1, Hao Xie1, Qinfeng Yang1, Zhanjun Shi1,()   

  1. 1. Department of Orthopaedic Surgery, Division of Orthopaedics, Nanfang Hospital, Southern Medical University,Guangzhou 510515,China
  • Received:2023-11-16 Published:2025-02-05
  • Corresponding author: Zhanjun Shi
引用本文:

包良笑, 刘兆锋, 谢豪, 杨钦烽, 史占军. 美国住院患者膝关节翻修术后肺部并发症发病率及危险因素分析[J/OL]. 中华老年骨科与康复电子杂志, 2025, 11(01): 4-13.

Liangxiao Bao, Zhaofeng Liu, Hao Xie, Qinfeng Yang, Zhanjun Shi. Incidence and risk factors of pulmonary complications after revision knee arthroplasty based on USA National Inpatient Sample[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2025, 11(01): 4-13.

目的

评估美国住院患者膝关节翻修术(RKA)后肺部并发症(PPC)的发病率及相关危险因素,以期为临床风险预测和围术期管理提供参考。

方法

本研究回顾性分析2015至2019年美国的全国住院患者样本(NIS)数据库中,RKA 患者的资料。采用Wilcoxon 秩和检验(计量资料)和卡方检验(计数资料)评估患者的人口学指标、合并症、住院时间、住院总费用以及住院期间的死亡率;并通过logistic回归分析寻找导致RKA后PPC发生的危险因素。

结果

共纳入NIS数据库74 364例RKA患者样本。RKA后PPC的总发病率为2.69%,发病率在2015-2016降低,然后从2016至2019缓慢上升,总体来说趋于平缓。RKA后出现PPC的患者有更多合并症数量、更长的住院时长、较高的住院费用以及住院期间死亡率。除此以外,他们更多使用医保进行支付(P<0.001)。术后PPC 的危险因素包括大医院(OR=1.22,P<0.001)、非急诊/择期住院(OR=0.23,P<0.001)、教学医院(OR=0.23,P<0.001)、高龄(OR=1.20,P<0.001)、酒精滥用(酗酒)(OR=1.64,P<0.001)、营养性贫血(OR=1.26,P<0.001)、充血性心力衰竭(OR=2.51,P<0.001)、慢性肺部疾病(OR=1.78,P<0.001)、凝血功能障碍(OR=2.25,P<0.001)、水电解质紊乱(OR=4.34,P<0.001)、转移癌(OR=2.39,P<0.001)、神经系统疾病(OR=4.76,P<0.001)、肥胖(OR=1.50,P<0.001)、瘫痪(OR=2.10,P<0.001)、外周血管疾病(OR=1.37,P<0.001)、肺循环功能障碍(OR=2.61,P<0.001)、肾衰竭(OR=1.21,P<0.001)、体重减轻(营养不良)(OR=2.99,P<0.001)、深静脉血栓(OR=6.09,P<0.001)、术后谵妄(OR=4.84,P<0.001)、心力衰竭(OR=1.19,P<0.001)、败血症(OR=12.91,P<0.001)和伤口破裂(OR=1.13,P<0.001)。

结论

RKA 后PPC 的总体发病率较低,但仍需关注高危患者群体。多种合并症及围术期因素与PPC的发生密切相关,特别是心肺功能受损、凝血功能障碍及营养不良等因素显著增加PPC风险。术前充分评估并优化相关危险因素,有助于降低术后PPC发生率,改善患者预后。

Objective

The aim of this study is to determine the incidence and risk factors of pulmonary complications after revision knee arthroplasty.

Methods

This study conducted a retrospective analysis of patients undergoing revision knee arthroplasty using the National Inpatient Sample Database (NIS) in the United States from 2015 to 2019.This study used Wilcoxon test(continuous data)and Chi square test(categorical data)to analyze patients'demographic indicators,comorbidities,length of stay,total hospitalization expenses,and mortality during hospitalization;And through logistic regression analysis,identify the risk factors leading to pulmonary complications after revision knee arthroplasty.

Results

74 364 patient samples of revision knee arthroplasty were obtained from the NIS database.The total incidence of pulmonary complications after revision knee arthroplasty was 2.69%, and the incidence rate decreased from 2015 to 2016, then slowly in-creased from 2016 to 2019, and generally leveled off. Patients with pulmonary complications after revision knee arthroplasty have a higher number of comorbidities,longer hospital stay,higher hospitalization cost,and mortality during hospitalization.In addition,they use medical insurance more for payment(P<0.001).Risk factors for developing PPC after RKAincluded being treated at a large hospital(OR=1.22,P<0.001),non-emergency/elective admission(OR=0.23,P<0.001),treatment at a teaching hospital(OR=0.23,P<0.001),advanced age(OR=1.20,P<0.001),alcohol abuse(OR=1.64,P<0.001),nutritional anemia(OR=1.26,P<0.001),congestive heart failure(OR=2.51,P<0.001),chronic lung disease(OR=1.78,P<0.001),coagulation disorders(OR=2.25,P<0.001),fluid and electrolyte disorders(OR=4.34,P<0.001),metastatic cancer(OR=2.39,P<0.001),neurological disorders(OR=4.76,P<0.001),obesity(OR=1.50,P<0.001),paralysis(OR=2.10,P<0.001),peripheral vascular disease(OR=1.37,P<0.001),pulmonary circulation disorders(OR=2.61,P<0.001),renal failure(OR=1.21, P<0.001), weight loss (malnutrition) (OR=2.99, P<0.001), deep vein thrombosis (OR=6.09, P<0.001),postoperative delirium(OR=4.84,P<0.001),heart failure(OR=1.19,P<0.001),sepsis(OR=12.91,P<0.001),and wound dehiscence(OR=1.13,P<0.001).

Conclusion

The incidence of pulmonary complications after revision knee arthroplasty is relatively low.Early examination and identification of risk factors related to postoperative pulmonary complications can help make appropriate treatment in advance and mitigate the consequences.

表1 研究中使用的ICD-9和ICD-10编码
表2 纳入本研究统计分析具体变量
图1 美国NIS数据库膝关节翻修术后肺部并发症2015-2019年发病率变化柱形图 注:NIS:全国住院患者样本;RKA:膝关节翻修术;PPC:术后肺部并发症
表3 RKA后发生PPC患者的临床特征单因素分析(2015~2019)
表4 RKA后发生PPC的术前合并症单因素分析
术前合并症 非PPC组 PPC组 统计值 P
艾滋病 156(0.22%) 2(0.11%) f=1.220 0.272
酒精滥用(酗酒) 1 002(1.38%) 83(4.15%) f=103.623 <0.001
营养性贫血 3 268(4.52%) 202(10.11%) f=136.601 <0.001
类风湿关节炎/胶原血管疾病 4 288(5.93%) 159(7.95%) f=14.241 <0.001
慢性失血性贫血 737(1.02%) 37(1.85%) f=13.094 <0.001
充血性心力衰竭 4 595(6.35%) 567(28.36%) f=1459.428 <0.001
慢性肺部疾病 14 228(19.66%) 695(34.77%) f=276.731 <0.001
凝血功能障碍 2 312(3.19%) 295(14.76%) f=768.781 <0.001
抑郁症 13 344(18.44%) 429(21.46%) f=11.760 <0.001
无并发症糖尿病 12 410(17.15%) 335(16.76%) f=0.214 0.650
药物滥用 1 313(1.81%) 70(3.50%) f=273.244 <0.001
高血压 50 936(70.39%) 1 511(77.59%) f=30.342 <0.001
甲状腺功能减退症 12 787(17.67%) 415(20.76%) f=48.579 <0.001
肝脏疾病 2 314(3.20%) 150(7.50%) f=12.718 <0.001
淋巴瘤 233(0.32%) 9(0.45%) f=112.592 0.324
水电解解质紊乱 7 774(10.74%) 966(48.32%) f=0.990 <0.001
转移癌 126(0.17%) 16(0.80%) f=2648.961 <0.001
神经系统疾病 1 671(2.31%) 380(19.01%) f=40.034 <0.001
肥胖 23 850(32.96%) 899(44.97%) f=126.462 <0.001
瘫痪 245(0.34%) 27(1.35%) f=54.682 <0.001
外周血管疾病 2 422(3.35%) 153(7.65%) f=107.944 <0.001
精神病 2 439(3.37%) 119(5.95%) f=39.062 <0.001
肺循环功能障碍 1 041(1.44%) 194(9.70%) f=813.901 <0.001
肾衰竭 7 183(9.93%) 489(24.46%) f=444.241 <0.001
未转移的实体肿瘤 588(0.81%) 38(1.90%) f=27.613 <0.001
心脏瓣膜病 3 214(4.44%) 210(10.51%) f=6.542 <0.001
体重减轻(营养不良) 1 090(1.51%) 227(11.36%) f=162.846 <0.001
伴有慢性并发症的糖尿病 6 955(9.61%) 416(20.81%) f=1084.771 <0.001
消化性溃疡疾病 255(0.35%) 14(0.70%) f=2022.901 0.001
表5 RKA后发生PPC的多因素logistic回归分析
表6 调整后不同术前合并症RKA患者的PPC风险
术前合并症 多元logistic 回归分析
β SE Wald OR 95%CI P
酒精滥用(酗酒) 0.493 0.136 13.146 1.64 1.25,2.14 <0.001
营养性贫血 0.234 0.085 7.529 1.26 1.07,1.49 0.001
类风湿关节炎/胶原血管疾病 0.136 0.091 2.245 1.15 0.96,1.37 0.127
慢性失血性贫血 0.132 0.188 0.496 1.14 0.79,1.65 0.5479
充血性心力衰竭 0.918 0.062 217.431 2.51 2.22,2.83 <0.001
慢性肺部疾病 0.577 0.053 120.313 1.78 1.61,1.97 <0.001
凝血功能障碍 0.81 0.08 103.282 2.25 1.92,2.63 <0.001
抑郁症 0.005 0.06 0.008 1.01 0.89,1.13 0.929
药物滥用 0.0011 0.065 0.029 1.12 0.85,1.47 0.431
高血压 0.097 0.068 1.999 1.04 0.92,1.17 0.537
甲状腺功能减退症 0.111 0.141 0.622 1.31 0.93,1.17 0.490
肝脏疾病 0.037 0.061 0.379 1.04 0.85,1.28 0.688
水电解解质紊乱 0.042 0.105 0.159 4.34 3.92,4.8 <0.001
转移癌 1.467 0.052 799.163 2.39 1.3,4.39 <0.001
神经系统疾病 0.869 0.311 7.801 4.76 4.14,5.47 <0.001
肥胖 1.56 0.071 480.908 1.40 1.27,1.55 <0.001
瘫痪 0.339 0.05 45.841 2.10 1.34,3.31 <0.001
外周血管疾病 0.744 0.231 10.327 1.37 1.13,1.66 <0.001
精神病 0.314 0.097 10.456 1.31 1.06,1.61 0.001
肺循环功能障碍 0.268 0.107 6.289 2.61 2.15,3.17 <0.001
肾衰竭 0.96 0.098 95.153 1.21 1.06,1.37 <0.001
未转移的实体肿瘤 0.19 0.065 8.431 1.30 0.88,1.92 0.182
心脏瓣膜病 0.261 0.2 1.709 1.19 1.01,1.42 0.040
体重减轻(营养不良) 0.444 0.303 2.147 2.99 2.5,3.56 <0.001
伴有慢性并发症的糖尿病 0.176 0.087 4.057 1.10 0.96,1.26 0.181
消化性溃疡疾病 1.094 0.09 148.555 1.56 0.86,2.83 0.142
表7 调整后出现术后并发症RKA患者的PPC风险
1
Khan M,Osman K,Green G,et al.The epidemiology of failure in total knee arthroplasty: avoiding your next revision [J]. Bone Joint J,2016,98-b(1 Suppl A):105-112.
2
Kong LD, Cao JM, Zhang YZ, et al. Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty:a meta-analysis[J].Int Wound J,2017,14(3):529-536.
3
Pulido L,Ghanem E,Joshi A,et al.Periprosthetic joint infection:the incidence, timing, and predisposing factors [J]. Clin Orthop Relat Res,2008,466(7):1710-1715.
4
Kurtz S,Ong K,Lau E,et al.Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030 [J]. J Bone Joint Surg Am,2007,89(4):780-785.
5
Cram P, Lu X, Kates SL, et al.Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010 [J].JAMA,2012,308(12):1227-1236.
6
Kurtz SM,Ong KL,Lau E,et al.International survey of primary and revision total knee replacement[J].Int Orthop,2011,35(12):1783-1789.
7
Miskovic A, Lumb AB. Postoperative pulmonary complications [J].Br J Anaesth,2017,118(3):317-334.
8
Güldner A,Kiss T,Serpa Neto A,et al.Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure,and lung recruitment maneuvers[J].Anesthesiology,2015,123(3):692-713.
9
Yang QF,Wang J,Xu YC,et al.Incidence and risk factors of in-hospital prosthesis-related complications following total hip arthroplasty: a retrospective Nationwide Inpatient Sample database study [J].Int Orthop,2020,44(11):2243-2252.
10
Joo MK,Yoo JW,Mojtahedi Z,et al.Ten-year trends of utilizing palliative care and palliative procedures in patients with gastric Cancer in the United States from 2009 to 2018-a nationwide database study[J].BMC Health Serv Res,2022,22(1):20.
11
黄艳群,张慧,王妮,等.基于美国住院病人样本的脑血管疾病预后影响因素研究进展[J].中国医院统计[J],2018,25(02):111-114.
12
杨钦烽,王健,张洋,等.美国住院病人髋膝关节置换术后谵妄发生率及危险因素[J].中华关节外科杂志:电子版[J],2021,15(01):57-63.
13
Ma Y, Passias P, Gaber-Baylis LK, et al. Comparative in-hospital morbidity and mortality after revision versus primary thoracic and lumbar spine fusion[J].Spine J,2010,10(10):881-889.
14
Jämsen E, Peltola M, Eskelinen A, et al. Comorbid diseases as predictors of survival of primary total hip and knee replacements: a nationwide register-based study of 96 754 operations on patients with primary osteoarthritis[J].Ann Rheum Dis,2013,72(12):1975-1982.
15
Nickel BT, Klement MR, Penrose CT, et al. Lingering risk: bariatric surgery before total knee arthroplasty [J]. J Arthroplasty, 2016, 31(9 Suppl):207-211.
16
Sloan M, Sheth N, Lee GC. Is obesity associated with increased risk of deep vein thrombosis or pulmonary embolism after hip and knee arthroplasty?a large database study[J].Clin Orthop Relat Res,2019,477(3):523-532.
17
Malcolm TL, Knezevic NN, Zouki CC, et al. Pulmonary complications after hip and knee arthroplasty in the United States, 2004-2014[J].Anesth Analg,2020,130(4):917-924.
18
Brodeur PG, Boduch A, Kim KW, et al. Surgeon and facility volumes are associated with social disparities and Post-Operative complications after total hip arthroplasty [J]. J Arthroplasty, 2022, 37(8s):S908-S918.e1.
19
Chen J, Tian Z, Zhang HX, et al. Risks of postoperative respiratory failure in elderly patients after hip surgery: a retrospective study [J].J Orthop Surg Res,2022,17(1):140.
20
Liu SS, Della Valle AG, Besculides MC, et al. Trends in mortality,complications, and demographics for primary hip arthroplasty in the United States[J].Int Orthop,2009,33(3):643-651.
21
Rasouli MR,Tabatabaee RM, Maltenfort MG, et al.Acute stroke after total joint arthroplasty: a population-based trend analysis [J]. J Clin Anesth,2016,34:15-20.
22
Kreder HJ, Grosso P, Williams JI, et al. Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario[J].Can J Surg,2003,46(1):15-22.
23
Himanen AK, Belt E, Nevalainen J, et al. Survival of the AGC total knee arthroplasty is similar for arthrosis and rheumatoid arthritis.Finnish Arthroplasty Register report on 8,467 operations carried out between 1985 and 1999[J].Acta Orthop,2005,76(1):85-88.
24
Vessely MB,Whaley AL,Harmsen WS,et al.The chitranjan ranawat award: long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties [J]. Clin Orthop Relat Res, 2006,452:28-34.
25
Gioe TJ,Novak C,Sinner P,et al.Knee arthroplasty in the young patient: survival in a community registry [J]. Clin Orthop Relat Res,2007,464:83-87.
26
Kim YH,Choi Y,Kim JS.Influence of patient-,design-,and surgeryrelated factors on rate of dislocation after primary cementless total hip arthroplasty[J].J Arthroplasty,2009,24(8):1258-1263.
27
Meek RMD, Norwood T, Smith R, et al. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement[J].J Bone Joint Surg Br,2011,93(1):96-101.
28
Khatod M,Cafri G,Namba RS,et al.Risk factors for total hip arthroplasty aseptic revision[J].J Arthroplasty,2014,29(7):1412-1417.
29
杨钦烽.全髋关节置换术后院内假体并发症的发生率及危险因素分析[D].广州:南方医科大学,2022.
30
Sams JD, Milbrandt JC, Froelich JM, et al. Hospital outcome after emergent vs elective revision total hip arthroplasty [J]. J Arthroplasty,2010,25(5):826-828.
31
Lenguerrand E,Whitehouse MR,Beswick AD,et al.Risk factors associated with revision for prosthetic joint infection after hip replacement:a prospective observational cohort study[J].Lancet Infect Dis,2018,18(9):1004-1014.
32
Kurtz SM,Lau EC,Ong KL,et al.Which clinical and patient factors influence the National economic burden of hospital readmissions after total joint arthroplasty? [J]. Clin Orthop Relat Res, 2017, 475(12):2926-2937.
33
Zhu Y,Zhang F,Chen W,et al.Risk factors for periprosthetic joint infection after total joint arthroplasty: a systematic review and metaanalysis[J].J Hosp Infect,2015,89(2):82-89.
34
Kawano SSE,Sonohata M,Kitajima M,et al.Risk factors for the development of nerve palsy following primary total hip arthroplasty[J].Open Orthop J,2018,12:164-172.
35
Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty [J].Anesthesiology,2003,99(3):552-560.
36
Memtsoudis SG,Besculides MC,Gaber L,et al.Risk factors for pulmonary embolism after hip and knee arthroplasty: a populationbased study[J].Int Orthop,2009,33(6):1739-1745.
37
Zahir U, Sterling RS, Pellegrini VDJ, et al. Inpatient pulmonary embolism after elective primary total hip and knee arthroplasty in the United States[J].J Bone Joint Surg Am,2013,95(22):e175.
38
Levine JM, Menezes R, Namagiri S. Wounds related to malignancy in postacute and long-term care: a case series [J]. Adv Skin Wound Care,2020,33(2):99-102.
39
Ko PS, Chan WF, Siu TH, et al. Deep venous thrombosis after total hip or knee arthroplasty in a"low-risk"Chinese population[J].J Arthroplasty,2003,18(2):174-179.
40
Liu LM,Liu HT,Zhang H,et al.Bilateral total knee arthroplasty:Simultaneous or staged? A systematic review and meta-analysis [J].Medicine(Madr),2019,98(22):e15931.
41
Brimmo O,Glenn M,Klika AK,et al.Rivaroxaban use for thrombosis prophylaxis is associated with early periprosthetic joint infection[J].J Arthroplasty,2016,31(6):1295-1298.
42
Bohl DD, Sershon RA, Fillingham YA, et al. Incidence, risk factors,and sources of sepsis following total joint arthroplasty [J]. J Arthroplasty,2016,31(12):2875-2879.e2.
43
Dimick JB,Chen SL,Taheri PA,et al.Hospital costs associated with surgical complications:a report from the private-sector National Surgical Quality Improvement Program [J]. J Am Coll Surg, 2004, 199(4):531-537.
44
Khuri SF,Henderson WG,DePalma RG,et al.Determinants of longterm survival after major surgery and the adverse effect of postoperative complications[J].Ann Surg,2005,242(3):326-341;discussion 341-3.
[1] 谢云港, 范长海, 刘荣顺, 邓瑞晨. 不同术式治疗内侧间室膝骨关节炎的疗效[J/OL]. 中华关节外科杂志(电子版), 2024, 18(06): 720-728.
[2] 李伊尧, 许杰. 远程全膝关节置换术随访及膝关节功能评价的进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(06): 790-794.
[3] 苏介茂, 齐岩松, 王永祥, 魏宝刚, 马秉贤, 张鹏飞, 魏兴华, 徐永胜. 关节镜手术在早中期膝骨关节炎治疗的应用进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 646-652.
[4] 赵飞鸿, 陈颖杰, 林静芳, 郑晓春, 廖燕凌. 超声引导下周围神经阻滞对髋膝关节置换术后恢复的影响[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 457-468.
[5] 高小康, 张净宇, 刘金伟, 田东牧, 胡永成, 徐卫国. 连接型人工膝关节假体运动和负重模式的演变和进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 505-516.
[6] 杨滢甄, 黄子荣, 梁家敏, 黄晓芳, 胡艳, 朱伟民. 膝关节前交叉韧带重建术前康复治疗的研究进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 538-544.
[7] 王铭池, 梁乐琦, 刘永达. 基于NHANES数据库分析血脂与肾结石之间的关系[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 485-490.
[8] 高瑞, 康迪斯, 秦蘅, 胡月明, 初同伟, 代丽. 加速康复管理改善膝关节置换术后肺部感染并发症和疗效的Meta分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 234-237.
[9] 杨凤霞, 张英, 尤楠, 王霞, 黄小兵, 冯欢. 原位肝移植术后肺部并发症的诊疗进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 329-331.
[10] 杨秀君, 崔梦莹, 刘水, 盛基尧, 张丹. 基于SEER数据库胰头部胰腺神经内分泌癌患者预后列线图构建与验证[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 520-525.
[11] 张蔚林, 王哲学, 白峻阁, 黄忠诚, 肖志刚. 利用TCGA数据库构建基于miRNA的结直肠癌列线图预后模型[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 381-388.
[12] 宋庆成, 郑占乐, 王天瑞, 王宇钏, 张凯旋, 纳静, 蔚佳昊, 杨思繁, 宋九宏, 张英泽. “人老膝不老”:膝关节健康管理的全方位探索与实践[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 321-324.
[13] 郑占乐, 王宇钏, 蔚佳昊, 宋庆成, 张凯旋, 纳静, 王天瑞, 宋九宏, 张英泽, 王娟. 保膝须“开膝”——“开膝”在膝骨关节炎中的临床应用价值[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 325-330.
[14] 王浩汀, 尚运涛, 曹光, 张延祠, 李军勇. 胫骨高位截骨联合关节镜与单髁置换治疗单间室膝关节骨性关节炎的临床疗效比较[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(04): 229-236.
[15] 于晓光, 秦永辉, 李佳, 贾国兴, 李军, 赵振栓, 刘国彬. 人工单髁置换术治疗膝关节内侧间室骨关节炎合并前交叉韧带功能不良的近期疗效[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 337-342.
阅读次数
全文


摘要