Hauk C, Heyse T J, Witteborn M C P, Schofer M D, Fuchs-Winkelmann S, Schmitt J
Klinik für Orthopädie und Rheumatologie, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg.
Z Orthop Unfall. 2009 Mar-Apr;147(2):183-7. doi: 10.1055/s-0029-1185518. Epub 2009 Apr 8.
The aim of the present retrospective matched pair study was to compare the clinical results of patients undergoing total knee arthroplasty (TKA) with 2 different operation strategies: tibia first vs. femur first for ligament balancing and rotational alignment of the femoral component.
In this study 30 patients underwent TKA with the fixed bearing prosthesis Innex FIXUC between 2003 and 2005. In the same period of time the posterior stabilised prosthesis NexGen LPS was implanted in 123 patients. Out of these, 30 patients were matched to the 30 patients of the Innex group based on the parameters age, gender, height, weight and BMI. All implants were cemented. Clinical examination was rated using UCLA score, Knee Society score, Lequesne score for knees, a visual analogue scale (VAS) for pain and the Feller patellar score. Three patients in the Innex group were lost to follow-up, and 27 matched pairs could finally be analysed.
At a mean follow-up of 25 months (Innex) and 3 years (NexGen) statistically significant differences (p < 0.05) with advantages for the NexGen were found in the UCLA activity score (4.9 vs. 5.9, p = 0.013), in part A (knee score) of the Knee Society score (78.9 vs. 91.0, p = 0.002) as well as the total score (153.9 vs. 173.2, p = 0.012), VAS (2.1 vs. 0.6, p = 0.003) and in the Lequesne knee score (5.7 vs. 3.6, p = 0.024). No statistically significant differences (p < 0.05) were found in the function score of the Knee Society score and the patellar score (Feller).
In the described setting there were functional advantages for the NexGen prosthesis (femur first) at a comparable revision rate. However, satisfactory results with the Innex FIXUC are possible, too.
本回顾性配对研究的目的是比较接受全膝关节置换术(TKA)的患者采用两种不同手术策略的临床结果:胫骨优先与股骨优先,用于韧带平衡和股骨组件的旋转对齐。
本研究中,30例患者在2003年至2005年间接受了使用固定承重假体Innex FIXUC的TKA。在同一时期,123例患者植入了后稳定型假体NexGen LPS。其中,30例患者根据年龄、性别、身高、体重和BMI等参数与Innex组的30例患者进行配对。所有植入物均采用骨水泥固定。临床检查采用UCLA评分、膝关节协会评分、膝关节Lequesne评分、疼痛视觉模拟量表(VAS)和费勒髌骨评分。Innex组有3例患者失访,最终可分析27对配对。
平均随访25个月(Innex组)和3年(NexGen组),在UCLA活动评分(4.9对5.9,p = 0.013)、膝关节协会评分的A部分(膝关节评分)(78.9对91.0,p = 0.002)以及总分(153.9对173.2,p = 0.012)、VAS(2.1对0.6,p = 0.003)和Lequesne膝关节评分(5.7对3.6,p = 0.024)方面发现了具有统计学意义的差异(p < 0.05),NexGen组具有优势。在膝关节协会评分的功能评分和髌骨评分(费勒)方面未发现统计学意义的差异(p < 0.05)。
在所述情况下,NexGen假体(股骨优先)在可比的翻修率下具有功能优势。然而,Innex FIXUC也可能取得令人满意的结果。