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KineSpring膝关节植入系统的中期疗效及临床成功的预测因素

Midterm Outcomes and Predictors of Clinical Success With the KineSpring Knee Implant System.

作者信息

London Nicholas J, Smith Jon, Miller Larry E, Block Jon E

机构信息

Department of Orthopaedic Surgery, Harrogate District Foundation Trust, Harrogate, United Kingdom.

出版信息

Clin Med Insights Arthritis Musculoskelet Disord. 2013 May 13;6:19-28. doi: 10.4137/CMAMD.S11768. Print 2013.

DOI:10.4137/CMAMD.S11768
PMID:23761985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3662395/
Abstract

The purpose of this study was to (1) evaluate joint pain and function in knee osteoarthritis (OA) patients treated with a joint-sparing, extracapsular implant and (2) identify patient characteristics that influenced clinical outcomes. This study included 99 patients with symptomatic medial knee OA refractory to conservative care who were treated with the KineSpring Knee Implant System and followed for a mean of 17 months (range, 1.5 to 48 months). All devices were successfully implanted and activated with no intraoperative complications. Statistically significant mean improvements of 56%, 50%, and 38% were observed for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain, Function, and Stiffness scales, respectively (all P < 0.001). Regardless of gender, age group, body mass index classification, or disease severity, all WOMAC domain scores significantly improved during the postoperative follow-up period. WOMAC clinical success rates were 77.8% for Pain, 77.8% for Function, and 68.7% for Stiffness. Neither gender, age group, body mass index classification, nor disease severity predicted clinical success in any WOMAC domain. In conclusion, the KineSpring System yields clinically meaningful improvements in joint pain and function in patients with medial knee OA. Additionally, unlike joint-altering procedures such as knee arthroplasty or high tibial osteotomy, patient characteristics had little association with postoperative clinical outcomes.

摘要

本研究的目的是

(1)评估采用保留关节的关节外植入物治疗的膝关节骨关节炎(OA)患者的关节疼痛和功能;(2)确定影响临床结局的患者特征。本研究纳入了99例经保守治疗无效的有症状的膝关节内侧OA患者,这些患者接受了KineSpring膝关节植入系统治疗,平均随访17个月(范围1.5至48个月)。所有装置均成功植入并激活,无术中并发症。西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛、功能和僵硬量表的平均改善率分别为56%、50%和38%,差异有统计学意义(均P < 0.001)。无论性别、年龄组、体重指数分类或疾病严重程度如何,所有WOMAC领域评分在术后随访期间均显著改善。WOMAC疼痛、功能和僵硬的临床成功率分别为77.8%、77.8%和68.7%。性别、年龄组、体重指数分类或疾病严重程度均不能预测任何WOMAC领域的临床成功。总之,KineSpring系统在膝关节内侧OA患者的关节疼痛和功能方面产生了具有临床意义的改善。此外,与诸如膝关节置换术或高位胫骨截骨术等改变关节的手术不同,患者特征与术后临床结局几乎没有关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43e/3662395/8d158ca624b2/cmamd-6-2013-019f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43e/3662395/71192aad0f45/cmamd-6-2013-019f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43e/3662395/8d158ca624b2/cmamd-6-2013-019f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43e/3662395/71192aad0f45/cmamd-6-2013-019f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43e/3662395/8d158ca624b2/cmamd-6-2013-019f2.jpg

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本文引用的文献

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The cost-effectiveness of total joint arthroplasty: a systematic review of published literature.全关节置换术的成本效益:已发表文献的系统评价。
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The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review.肥胖对全膝关节置换术并发症发生率和结局的影响:荟萃分析和系统文献回顾。
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有症状的轻至中度膝关节骨关节炎的手术干预措施。
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