Bergschmidt Philipp, Bader Rainer, Finze Susanne, Schulze Christoph, Kundt Guenther, Mittelmeier Wolfram
Department of Orthopaedics, University of Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany.
Open Orthop J. 2011;5:354-60. doi: 10.2174/1874325001105010354. Epub 2011 Oct 7.
Hypersensitivity reactions to implant materials have become more important in total knee replacement (TKR). The purpose of this retrospective comparative study was to evaluate the clinical and radiological outcomes of unconstrained bicondylar total knee prostheses with and without anti-allergic titanium(niobium)nitrite (Ti(Nb)N) coating.
Twenty-four patients (25 TKRs) underwent a preoperative clinical evaluation and then a postoperative evaluation after 26.2 months in the allergy group treated with coated implants (n=13 implants) and after 24.5 months in the control group treated with uncoated implants but identical geometry (n=12) using HSS, WOMAC and SF-36 scores. Radiological evaluations were performed using standard anterior-posterior (a.p.) and lateral X-rays.
During follow-up two patients of the allergy group had to undergo revision surgery due to non-implant-related reasons. A comparative analysis of both study groups showed a significant difference in the HSS scores at both evaluation time points (MW test p≤0.050); these findings are remarkable since the control group had a significantly lower score preoperatively (54.0 vs 65.0 points) and a significantly higher score (82.5 vs 75.0 points) postoperatively. The preoperative and postoperative WOMAC and SF-36 scores were comparable in both groups (MW test p≥0.052), although the postoperative increase in the score for the allergy group was lower. The radiological results were comparable in both groups and were unlikely to influence the results.
This clinical study demonstrates the restricted outcome in postoperative function and quality of life in the allergy group compared to the control group.
在全膝关节置换术（TKR）中，对植入材料的过敏反应变得愈发重要。本回顾性对照研究的目的是评估有无抗过敏性亚硝酸钛（铌）（Ti(Nb)N）涂层的非限制性双髁全膝关节假体的临床和放射学结果。
24例患者（25次TKR）在术前进行了临床评估，然后在使用HSS、WOMAC和SF - 36评分的情况下，对接受涂层植入物治疗的过敏组（n = 13个植入物）术后26.2个月以及接受未涂层但几何形状相同的植入物治疗的对照组（n = 12）术后24.5个月进行了评估。使用标准前后位（a.p.）和侧位X线进行放射学评估。
在随访期间，过敏组有2例患者因非植入物相关原因接受了翻修手术。两个研究组的比较分析显示，在两个评估时间点的HSS评分均有显著差异（MW检验p≤0.050）；这些发现很显著，因为对照组术前评分显著较低（54.0对65.0分），术后评分显著较高（82.5对75.0分）。两组术前和术后的WOMAC和SF - 36评分相当（MW检验p≥0.052），尽管过敏组术后评分的增加较低。两组的放射学结果相当，不太可能影响结果。
本临床研究表明，与对照组相比，过敏组术后功能和生活质量的结果受限。
