The Joint Replacement Center of Korea, Ewha Womans University MokDong Hospital, 911-1, Mokdong, YangChun-Gu, Seoul 158-710, South Korea.
J Bone Joint Surg Am. 2010 Aug 18;92(10):1911-20. doi: 10.2106/JBJS.I.00910.
Recently, much debate has focused on the effect of gender-specific total knee arthroplasty. The purpose of the present study was to compare clinical and radiographic results as well as femoral component fit in patients receiving either a standard posterior cruciate-substituting LPS-Flex or gender-specific posterior cruciate-substituting LPS-Flex total knee prosthesis.
Sequential simultaneous bilateral total knee arthroplasty was performed for eighty-five patients (170 knees). Eighty-five women (mean age, 69.7 years) received a standard LPS-Flex prosthesis in one knee and a gender-specific LPS-Flex prosthesis in the contralateral knee. The mean duration of follow-up was 2.13 years. At each follow-up, the Knee Society score, the Hospital for Special Surgery knee score, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, and radiographs were evaluated. The aspect ratio of the distal part of the femur was compared with those of the standard LPS-Flex prosthesis and the gender-specific LPS-Flex prosthesis.
The mean postoperative Knee Society scores (95.5 points in the standard implant group, compared with 96.5 points in the gender-specific implant group) and Hospital for Special Surgery knee scores (90.7 points in the standard implant group, compared with 91.2 points in the gender-specific implant group) were similar in both groups. The mean postoperative WOMAC score was 36.6 points. Postoperatively, the mean ranges of knee motion in the supine position (125 degrees in the standard implant group, compared with 126 degrees in the gender-specific implant group), patient satisfaction (8.3 points in the standard implant group, compared with 8.1 points in the gender-specific implant group), and radiographic results were similar in both groups. The femoral component in the standard implant group fit significantly better than that in the gender-specific implant group (p < 0.0001).
The present study did not show any clinical benefits of a gender-specific LPS-Flex total knee prosthesis at the time of short-term follow-up. Longer follow-up is needed to determine whether there will be an advantage in terms of longer-term function.
Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
最近，人们对性别特异性全膝关节置换术的效果展开了大量讨论。本研究旨在比较接受标准后交叉韧带替代型 LPS-Flex 或性别特异性后交叉韧带替代型 LPS-Flex 全膝关节假体的患者的临床和影像学结果以及股骨部件适配情况。
对 85 例（170 膝）患者进行了连续同期双侧全膝关节置换术。85 名女性（平均年龄，69.7 岁）在一侧膝关节中接受标准 LPS-Flex 假体，在对侧膝关节中接受性别特异性 LPS-Flex 假体。平均随访时间为 2.13 年。在每次随访时，评估膝关节协会评分、特殊外科医院膝关节评分、西安大略和麦克马斯特大学骨关节炎（WOMAC）评分和影像学结果。比较股骨远端的纵横比与标准 LPS-Flex 假体和性别特异性 LPS-Flex 假体的比值。
两组患者的平均术后膝关节协会评分（标准假体组为 95.5 分，性别特异性假体组为 96.5 分）和特殊外科医院膝关节评分（标准假体组为 90.7 分，性别特异性假体组为 91.2 分）相似。平均术后 WOMAC 评分为 36.6 分。术后，仰卧位时膝关节活动范围的平均值（标准假体组为 125°，性别特异性假体组为 126°）、患者满意度（标准假体组为 8.3 分，性别特异性假体组为 8.1 分）和影像学结果在两组中均相似。标准假体组的股骨部件适配情况明显优于性别特异性假体组（p<0.0001）。
在短期随访中，本研究未发现性别特异性 LPS-Flex 全膝关节假体的任何临床优势。需要更长时间的随访以确定在长期功能方面是否存在优势。
治疗水平 I. 请参阅作者说明以获取完整的证据水平描述。
