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[无髌骨表面置换的性别特异性后稳定型全膝关节置换术的早期结果]

[Early results of gender-specific posterior stabilized total knee arthroplasty without patella resurfacing].

作者信息

von Roth P, Matziolis G, Pfitzner T, Mayr H O, Klein T, Preininger B, Winkler T, Hube R

机构信息

Centrum für Muskuloskeletale Chirurgie - Klinik für Orthopädie, Charité-Universitätsmedizin Berlin, Berlin, Deutschland,

出版信息

Orthopade. 2013 Oct;42(10):866-73. doi: 10.1007/s00132-013-2139-4.

Abstract

INTRODUCTION

To address anatomical gender differences in total knee arthroplasty (TKA) specific total knee prostheses have been developed for women. Potential benefits of these modified prostheses are currently under debate. The present study investigated whether the modified design features bring benefits compared to uni-sex TKA.

METHODS

A total of 80 prospectively blinded and randomized patients underwent implantation of unilateral TKAs with NexGen LPS Gender Solutions (Zimmer, Warsaw, USA, group gender-specific GS prosthesis, n = 40) or NexGen LPS Flex (Zimmer, Warsaw, USA, control group standard prosthesis ST, n = 40) The follow-up was carried out 10 days and 6 weeks postoperatively. Clinical data and the subjective assessment of quality of life were evaluated using the Knee Society Clinical Rating System (KSS), the short form 36-item health survey (SF-36) and the Western Ontario and McMaster Universities OA Index (WOMAC).

RESULTS

The two groups showed equal values in KSS, SF-36 and WOMAC preoperatively and ten days postoperatively the GS group reached an average KSS knee score of 62.6 ± 16.1 points (ST group 56.9 ± 14.7, p = 0.184) and a functional score of 28.5 ± 12.1 (ST group 24.3 ± 15.3, p = 0.082). In the overall score the GS group reached 91.1 ± 24.1 points (ST group 81.0 ± 27.1, p = 0.104). The GS group reached a knee score of 85.5 ± 14.4 points (ST group 77.8 ± 16.8, p = 0.03) and a functional score of 68.1 ± 20.7 points (ST group 62.3 ± 18.5, p = 0.185) 6 weeks postoperatively. In the overall score the GS group reached 153.7 ± 30.7 points (ST group 139.6 ± 32.4, p = 0.048). The analysis of SF-36 and WOMAC showed no significant differences at all time points. No evidence of loosening or migration was observed in both groups.

CONCLUSIONS

Based on the data presented, gender-specific TKA type NexGen LPS Gender Solutions has advantages in terms of early functional outcome. This result is not reflected in the patient satisfaction and is not considered to be clinically relevant.

摘要

引言

为解决全膝关节置换术(TKA)中的解剖学性别差异问题,已为女性开发了特定的全膝关节假体。目前,这些改良假体的潜在益处仍存在争议。本研究调查了与通用型TKA相比,改良设计特征是否带来益处。

方法

共有80例前瞻性设盲且随机分组的患者接受了单侧TKA植入,其中40例使用NexGen LPS Gender Solutions(美国华沙的Zimmer公司,特定性别GS假体组),40例使用NexGen LPS Flex(美国华沙的Zimmer公司,对照组标准假体ST)。术后10天和6周进行随访。使用膝关节协会临床评分系统(KSS)、简短36项健康调查(SF-36)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估临床数据和生活质量主观评估。

结果

两组在术前及术后10天的KSS、SF-36和WOMAC评分中表现相当,GS组的平均KSS膝关节评分为62.6±16.1分(ST组为56.9±14.7分,p = 0.184),功能评分为28.5±12.1分(ST组为24.3±15.3分,p = 0.082)。在总分中,GS组达到91.1±24.1分(ST组为81.0±27.1分,p = 0.104)。术后6周,GS组的膝关节评分为85.5±14.4分(ST组为77.8±16.8分,p = 0.03),功能评分为68.1±20.7分(ST组为62.3±18.5分,p = 0.185)。在总分中,GS组达到153.7±30.7分(ST组为139.6±32.4分,p = 0.048)。SF-36和WOMAC分析在所有时间点均未显示出显著差异。两组均未观察到松动或移位迹象。

结论

根据所呈现的数据,特定性别的TKA类型NexGen LPS Gender Solutions在早期功能结果方面具有优势。但这一结果未反映在患者满意度上,且不被认为具有临床相关性。

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