The prevalence and risk factors for peripheral nerve injury following arthroplasty: a systematic review and meta-analysis

关节置换术后周围神经损伤的发生率和危险因素:系统评价和荟萃分析

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Abstract

OBJECTIVE: To assess the prevalence and identify the risk factors for peripheral nerve injury (PNI) following arthroplasty through a systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane Library were searched for observational studies investigating the prevalence and risk factors for PNI following arthroplasty. Prevalence data for PNI following arthroplasty were extracted and pooled using a random-effects model, with results presented as pooled prevalence with 95% CI. ORs and 95% CIs for identified risk factors were calculated. Subgroup analyses were conducted based on age, study type, sample size, arthroplasty site, region, and others. Publication bias was assessed using funnel plots and Egger's test, and sensitivity analyses were performed. RESULTS: After screening, a total of 21 studies were included in the meta-analysis. The pooled prevalence of PNI was 0.7% (95% CI: 0.006-0.009) with significant heterogeneity (I² = 99%). The prevalence of PNI following arthroplasty was found to be more likely as a result of several identified factors, including spinal conditions (ORs = 2.269, 95% CI 1.625-3.170), postoperative anemia (ORs = 1.370, 95% CI 1.149-1.633), mechanical complications (ORs = 1.791, 95% CI 1.118-2.868) and hypothyroidism (ORs = 1.189, 95% CI 1.054-1.341). CONCLUSIONS: The pooled prevalence of PNI was approximately 0.7%. Furthermore, we identified potential risk factors for PNI following arthroplasty, including spinal conditions, postoperative anemia, mechanical complications, and hypothyroidism. Our findings emphasize the importance of recognizing these risk factors in the perioperative management of arthroplasty patients.

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