Singh Harjoban, Mittal Vivek, Nadkarni Biren, Agarwal Shekhar, Gulati Divesh
Department of Orthopaedics, Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital, Delhi, India.
J Orthop Surg (Hong Kong). 2012 Aug;20(2):153-6. doi: 10.1177/230949901202000203.
To compare outcomes in Indian women who underwent total knee arthroplasty (TKA) using the standard Legacy Posterior Stabilised (LPS) versus the gender-specific LPS high-flexion knee prosthesis.
100 women (200 knees) aged 60 to 80 years with an arc of flexion of ≥90º underwent simultaneous sequential TKA for primary osteoarthritis of both knees. They were randomised to receive the standard NexGen LPS prosthesis (n=50) or the gender-specific NexGen LPS High-Flex prosthesis (n=50). Both knees in each patient received the same prosthesis. The resected bone from the posterior femoral condyle was 2 mm greater when the gender-specific prosthesis was used. Patients were followed up at 3, 6, 12, and 24 months. Range of motion, Knee Society score, and Hospital for Special Surgery score were evaluated pre- and post-operatively by a single assessor.
The mean follow-up duration was 2.1 (range, 1.6-2.5) years. Respectively for the standard and gender-specific groups, the mean range of motion was 111º and 112º preoperatively and 120º and 123º at the latest follow-up. The gender-specific group gained approximately 3º more in range of motion (p=0.007). The Knee Society score and the Hospital for Special Surgery score between groups were not significantly different pre- and post-operatively.
The perceived advantage of a gender-specific prosthesis over a standard prosthesis did not translate into better clinical and functional outcome scores.
比较印度女性患者使用标准的传统后稳定型(LPS)全膝关节置换术(TKA)与特定性别LPS高屈曲膝关节假体的手术效果。
100名年龄在60至80岁、屈曲弧≥90º的女性(200膝)因双膝原发性骨关节炎同时接受序贯TKA。她们被随机分配接受标准的NexGen LPS假体(n = 50)或特定性别NexGen LPS高屈曲假体(n = 50)。每位患者的双膝均接受相同的假体。使用特定性别假体时,股骨后髁切除的骨量多2mm。患者在3、6、12和24个月时接受随访。由一名评估者在术前和术后评估活动范围、膝关节协会评分和特种外科医院评分。
平均随访时间为2.1年(范围1.6 - 2.5年)。标准组和特定性别组术前平均活动范围分别为111º和112º,最近一次随访时分别为120º和123º。特定性别组的活动范围增加了约3º(p = 0.007)。两组之间的膝关节协会评分和特种外科医院评分在术前和术后无显著差异。
特定性别假体相对于标准假体的预期优势并未转化为更好的临床和功能结果评分。