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前后稳定型与保留后交叉韧带型计算机导航全膝关节置换术中的对线改变。

Joint line changes in cruciate-retaining versus posterior-stabilized computer-navigated total knee arthroplasty.

机构信息

Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.

出版信息

Arch Orthop Trauma Surg. 2013 Jun;133(6):853-9. doi: 10.1007/s00402-013-1738-1. Epub 2013 Apr 16.

Abstract

INTRODUCTION

This study compared joint line changes and functional outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) computer-navigated total knee arthroplasties (TKAs). With the increased precision offered by computer navigation, we hypothesized that there should be minimal differences in the joint line changes between the groups and thus no significant differences in the clinical outcomes.

MATERIALS AND METHODS

A retrospective study of 195 patients with a minimum of 2-year follow-up following primary surgery was conducted. The patients were stratified into two groups: the CR group and the PS group. The joint line changes of both groups were then compared using the Student t test. Multivariate analysis and regression modelling were then utilized to analyze the functional outcomes of both groups.

RESULTS

CR knees had a significantly lesser mean joint line change of 1.70 mm as compared to 2.34 mm in PS knees (p = .04) but the absolute difference was only 0.64 mm. The PS group had significantly better final range of motion of 122° (±9.9°) as compared to 114° (±15.0°) in the CR group (p < .0001). There were no significant differences in the final outcome scores.

CONCLUSION

Although there is a significant difference statistically in the joint line changes between the groups, this difference is less than 1 mm and probably has no significant clinical impact. This is further affirmed by the fact that there was no significant difference in the clinical outcomes. The increased range seen in PS knees is probably not related to joint line changes.

LEVEL OF EVIDENCE

III.

摘要

简介

本研究比较了保留交叉韧带(CR)和后稳定(PS)计算机导航全膝关节置换术(TKA)的关节线变化和功能结果。由于计算机导航提供了更高的精度,我们假设两组之间的关节线变化应该很小,因此临床结果没有显著差异。

材料与方法

对 195 例接受初次手术并至少随访 2 年的患者进行了回顾性研究。将患者分为两组:CR 组和 PS 组。然后使用 Student t 检验比较两组的关节线变化。然后利用多元分析和回归模型分析两组的功能结果。

结果

CR 膝关节的平均关节线变化明显较小,为 1.70mm,而 PS 膝关节为 2.34mm(p=0.04),但绝对差值仅为 0.64mm。PS 组的最终活动范围明显更好,为 122°(±9.9°),而 CR 组为 114°(±15.0°)(p<0.0001)。最终结局评分无显著差异。

结论

尽管两组之间的关节线变化存在统计学上的显著差异,但这种差异小于 1mm,可能没有显著的临床影响。这进一步证实了临床结果没有显著差异的事实。PS 膝关节的活动范围增加可能与关节线变化无关。

证据水平

III。

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