开放楔形胫骨高位截骨术后感染的危险因素分析

赵加全; 简雯雯; 丁玉辉; 曾维君; 李丽娟; 张代英

doi:10.16016/j.2097-0927.202108051

您当前的位置：

首页 >

文章列表页 >

开放楔形胫骨高位截骨术后感染的危险因素分析

临床医学 | 更新时间：2026-01-09

- 开放楔形胫骨高位截骨术后感染的危险因素分析
- Risk factors for postoperative infection after open wedge high tibial osteotomy: an analysis of 114 cases
- 陆军军医大学学报 2022年44卷第5期页码：499-封3
- 作者机构：
  
  1.646000 四川泸州，西南医科大学附属医院：手术室
  2.646000 四川泸州，西南医科大学附属医院：心脏大血管外科
  3.646000 四川泸州，西南医科大学附属医院：麻醉科
- 作者简介：
  
  [ 张代英，E-mail: dyzhang11@163.com ZHANG Daiying, E-mail: dyzhang11@163.com
- 基金信息：
  
  泸州市社会公共安全理论与实践研究课题(SHAQYB2020006);泸州市社会公共安全理论与实践研究课题(SHAQ202103)
- DOI：10.16016/j.2097-0927.202108051
  中图分类号： R181.32;R619.3;R687.31
- 收稿：2021-08-09，
  
  修回：2021-09-12，
  
  纸质出版：2022-03-15
- 稿件说明：
移动端阅览
赵加全, 简雯雯, 丁玉辉, 等. 开放楔形胫骨高位截骨术后感染的危险因素分析[J]. 陆军军医大学学报, 2022,44(5):499-封3.

Jiaquan ZHAO, Wenwen JIAN, Yuhui DING, et al. Risk factors for postoperative infection after open wedge high tibial osteotomy: an analysis of 114 cases[J]. Journal of Army Medical University, 2022, 44(5): 499-封3.
赵加全, 简雯雯, 丁玉辉, 等. 开放楔形胫骨高位截骨术后感染的危险因素分析[J]. 陆军军医大学学报, 2022,44(5):499-封3. DOI： 10.16016/j.2097-0927.202108051.

Jiaquan ZHAO, Wenwen JIAN, Yuhui DING, et al. Risk factors for postoperative infection after open wedge high tibial osteotomy: an analysis of 114 cases[J]. Journal of Army Medical University, 2022, 44(5): 499-封3. DOI： 10.16016/j.2097-0927.202108051.

摘要

目的

探讨分析开放楔形胫骨高位截骨(opening wedge high tibial osteotomy，OWHTO)术后感染发生的危险因素。

方法

回顾性分析2017年8月至2020年10月期间于西南医科大学附属医院行初次OWHTO的114例患者病历，并完成术后定期随访，按照是否出现术后感染分为病例组和对照组，采用单因素及Logistic回归分析OWHTO术后感染的危险因素。

结果

纳入研究的114例患者中有31例出现术后感染，其中20例在术后2周内感染得以控制，11例在术后4周左右消除感染症状。多因素Logistic回归分析显示，糖尿病(

=0.001)、吸烟(

0.001)、截骨间隙≥10 mm(

=0.001)、术中植骨(

=0.001)、手术时间≥3 h(

0.001)是开放楔形胫骨高位截骨术后发生感染的独立危险因素(

0.05)。

结论

患有糖尿病、吸烟、截骨间隙≥10 mm、术中植骨、手术时间≥3 h的患者发生OWHTO术后感染的风险较高。

Abstract

Objective

To investigate the risk factors of postoperative infection after open wedge high tibial osteotomy (OWHTO).

Methods

Clinical data of 114 patients who underwent primary OWHTO in a Class A tertiary hospital from August 2017 to October 2020 were collected and retrospectively analyzed

and all of them completed regular postoperative follow-up. The patients were divided into control group and infection group according to the presence or absence of postoperative infection. Univariate and logistic regression analyses were used to explore the risk factors of infection after OWHTO.

Results

Among the 114 patients included in the study

31 cases had postoperative infection

of which 20 cases were controlled within 2 weeks after operation

and the symptoms of infection were eliminated in the other 11 cases about 4 weeks postoperatively. Multivariate logistic regression analysis showed that diabetes mellitus (

=0.001)

smoking (

0.001)

osteotomy clearance ≥10 mm (

=0.001)

bone graft (

=0.001)

and operation duration longer than 3 h (

0.001) were independent risk factors for postoperative infection (

0.05).

Conclusion

The patients with diabetes mellitus

smoking

osteotomy space ≥10 mm

intraoperative graft and operation time ≥3 h have a higher risk of infection after OWHTO.

关键词

Keywords

references

VAISHYA R, BIJUKCHHE A R, AGARWAL A K, et al . A critical appraisal of medial open wedge high tibial osteotomy for knee osteoarthritis[J ] . J Clin Orthop Trauma, 2018, 9(4): 300-306. DOI: 10.1016/j.jcot.2018.02.004.

MAEDA S, CHIBA D, SASAKI E, et al . The difficulty of continuing sports activities after open-wedge high tibial osteotomy in patient with medial knee osteoarthritis: a retrospective case series at 2-year-minimum follow-up[J ] . J Exp Orthop, 2021, 8(1): 1-8. DOI: 10.1186/s40634-021-00385-4.

CHAN KIM S, KIM D H, LEE J I, et al . Comparative analysis of serial union patterns after opening-wedge high tibial osteotomy with and without bone-void fillers[J ] . J Bone Joint Surg Am, 2021. DOI: 10.2106/JBJS.20.00778.

孙茂淋, 何锐, 郭林, 等. 开放楔形胫骨高位截骨术的临床应用及研究现状[J]. 中国修复重建外科杂志, 2019, 33(5): 640-643. DOI: 10.7507/1002-1892.201901014.

SUN M L, HE R, GUO L, et al . Clinical application and research status of open wedge high tibial osteotomy[J ] . Chin J Repar Reconstr Surg, 2019, 33(5): 640-643. DOI: 10.7507/1002-1892.201901014.

KIM K I, KIM G B, LEE M G, et al . Do we need chemoprophylaxis to prevent venous thromboembolism following medial open-wedge high tibial osteotomy?[J ] . J Knee Surg, 2021, 34(9): 1007-1013. DOI: 10.1055/s-0039-1700976.

LI H B, NIE S, LAN M, et al . Re-evaluating the necessity of routine laboratory tests after high tibial osteotomy surgery[J ] . BMC Musculoskelet Disord, 2021, 22(1): 1-7. DOI: 10.1186/s12891-021-04608-8.

FERNER F, LUTTER C, DICKSCHAS J, et al . Medial open wedge vs. lateral closed wedge high tibial osteotomy—Indications based on the findings of patellar height, leg length, torsional correction and clinical outcome in one hundred cases[J ] . Int Orthop, 2019, 43(6): 1379-1386. DOI: 10.1007/s00264-018-4155-9.

YANG J C, LOBENHOFFER P, CHANG C M, et al . A supplemental screw enhances the biomechanical stability in medial open-wedge high tibial osteotomy[J ] . PLoS One, 2020, 15(12): e0244557. DOI: 10.1371/ journal.pone.0244557.

LEE S Y, LIM H C, BAE J H, et al . Sagittal osteotomy inclination in medial open-wedge high tibial osteotomy[J ] . Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 823-831. DOI: 10.1007/s00167-016-4115-0.

OGINO T, KUMAGAI K, YAMADA S, et al . Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy[J ] . BMC Musculoskelet Disord, 2020, 21(1): 675. DOI: 10.1186/s12891-020-03703-6.

SUNDARARAJAN S R, NAGARAJA H S, RAJASEKARAN S. Medial open wedge high tibial osteotomy for Varus malunited tibial plateau fractures[J]. Arthroscopy, 2017, 33(3): 586-594. DOI: 10.1016/j.arthro.2016.08.027.

ZHU B, WANG T F, CHEN D S, et al . Postoperative bone marrow lesions (BMLs) are associated with pain severity in patients undergoing open wedge high tibial osteotomy (OWHTO)[J ] . Biomed Res Int, 2021, 2021: 9938037. DOI: 10.1155/2021/9938037.

KAWATA M, JO T, TAKETOMI S, et al . Type of bone graft and primary diagnosis were associated with nosocomial surgical site infect ion after high tibial osteotomy: analysis of a national database[J ] . Knee Surg Sports Traumatol Arthrosc, 2021, 29(2): 429-436. DOI: 10.1007/s00167-020-05943-4.

SEO S S, KIM O G, SEO J H, et al . Complications and short-term outcomes of medial opening wedge high tibial osteotomy using a locking plate for medial osteoarthritis of the knee[J ] . Knee Surg Relat Res, 2016, 28(4): 289-296. DOI: 10.5792/ksrr.16.028.

VAN HOUTEN A H, HEESTERBEEK P J, VAN HEERWAARDEN R J, et al . Medial open wedge high tibial osteotomy: can delayed or nonunion be predicted?[J ] . Clin Orthop Relat Res, 2014, 472(4): 1217-1223. DOI: 10.1007/s11999-013-3383-y.

ROSSI R, BONASIA D E, AMENDOLA A. The role of high tibial osteotomy in the Varus knee[J]. J Am Acad Orthop Surg, 2011, 19(10): 590-599. DOI: 10.5435/00124635-201110000-00003.

KIM M S, KOH I J, SUNG Y G, et al . Intravenous tranexamic acid has benefit for reducing blood loss after open-wedge high tibial osteotomy: a randomized controlled trial[J ] . J Clin Med, 2021, 10(15): 3272. DOI: 10.3390/jcm10153272.

ANAGNOSTAKOS K, MOSSER P, KOHN D. Infections after high tibial osteotomy[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 161-169. DOI: 10.1007/s00167-012-2084-5.

CARISSIMI M, SAUTET P, CHARRE D, et al . Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope[J ] . Orthop Traumatol Surg Res, 2021: 103032. DOI: 10.1016/j.otsr.2021.103032.

BAE J K, KIM J H, KIM K I, et al . Serial improvement of medial Meniscus extrusion following medial open-wedge high tibial osteotomy does not correlate with clinical outcomes and arthroscopic articular cartilage improvement[J ] . Arthroscopy, 2021. DOI: 10.1016/j.arthro.2021.07.024.

KIM J I, KIM B H, HAN H S, et al . Rotational changes in the Tibia after high tibial Valgus osteotomy: a comparative study of lateral closing versus medial opening wedge osteotomy[J ] . Am J Sports Med, 2020, 48(14): 3549-3556. DOI: 10.1177/0363546520960114.

SONG K Y, KOH I J, KIM M S, et al . Early experience of lateral hinge fracture during medial opening-wedge high tibial osteotomy: incidence and clinical outcomes[J ] . Arch Orthop Trauma Surg, 2020, 140(2): 161-169. DOI: 10.1007/s00402-019-03237-0.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

广泛耐药肺炎克雷伯菌感染的流行病学调查和危险因素分析

ICU创伤后感染患者并发脓毒症的危险因素分析

急性前循环大血管闭塞性卒中患者血管内治疗后发生卒中相关性肺炎的危险因素分析

核仁磷酸蛋白1突变的分子异质性对急性髓系白血病预后的影响

非肌层浸润性膀胱癌二次电切术后疗效评估及预后影响因素分析