Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2012 Jul 1;53(4):794-800. doi: 10.3349/ymj.2012.53.4.794.
The purpose of this study was to compare postoperative range of motion and functional outcomes among patients who received high-flexion total knee arthroplasty using cruciate-retaining (CR-Flex) and posterior-stabilized (PS-Flex) type prostheses.
Among 127 patients (186 knees) who underwent high-flexion total knee arthroplasty between 2005 and 2007, 92 knees were placed in the CR-Flex group, and 94 knees were placed in the PS-Flex group. After two years of postoperative follow-up, clinical and radiographic data were reviewed. Postoperative non-weight-bearing range of knee motion, angle of flexion contracture and functional outcomes based on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) functional sub-scale were assessed and compared between the two groups.
After the 2-year postoperative period, the mean range of motion was 131° in the CR-Flex group and 133° in the PS-Flex group. There were no significant differences in postoperative range of motion between the two groups. Only age at operation and preoperative range of motion were significantly associated with postoperative range of motion after high-flexion total knee arthroplasty. Postoperative functional outcomes based on the WOMAC functional sub-scale were slightly better in the CR-Flex group (9.2±9.1 points) than in the PS-Flex group (11.9±9.6 points); however, this difference was not statistically significant (p=non-significant).
The retention or substitution of the posterior cruciate ligament does not affect postoperative range of motion (ROM) or functional outcomes, according to 2 years of postoperative follow-up of high-flexion total knee arthroplasty.
本研究旨在比较使用保留后交叉韧带(CR-Flex)和后稳定型(PS-Flex)假体的高屈曲膝关节置换术后患者的关节活动范围和功能结果。
在 2005 年至 2007 年间接受高屈曲膝关节置换术的 127 例患者(186 膝)中,92 膝置于 CR-Flex 组,94 膝置于 PS-Flex 组。术后两年随访时,回顾临床和影像学资料。评估并比较两组患者术后非负重膝关节活动度、屈曲挛缩角度和基于西安大略和麦克马斯特大学骨关节炎(WOMAC)功能量表的功能结果。
在术后 2 年期间,CR-Flex 组的平均关节活动度为 131°,PS-Flex 组为 133°。两组患者术后关节活动度无显著差异。仅手术时年龄和术前关节活动度与高屈曲膝关节置换术后的关节活动度显著相关。基于 WOMAC 功能量表的术后功能结果,CR-Flex 组(9.2±9.1 分)略优于 PS-Flex 组(11.9±9.6 分);但差异无统计学意义(p=非显著)。
根据高屈曲膝关节置换术后 2 年的随访结果,保留或替代后交叉韧带并不影响术后关节活动度(ROM)或功能结果。