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在接受后稳定型全膝关节置换术的患者中,活动范围和功能不受术后约束增加的影响。

Range of motion and function are not affected by increased post constraint in patients undergoing posterior stabilized total knee arthroplasty.

作者信息

King Bryan R, Gladnick Brian P, Lee Yuo-yu, Lyman Stephen, Della Valle Alejandro González

机构信息

Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021, United States.

Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021, United States.

出版信息

Knee. 2014 Jan;21(1):194-8. doi: 10.1016/j.knee.2013.07.002. Epub 2013 Jul 27.

Abstract

BACKGROUND

Constrained primary total knee arthroplasty (TKA) can provide stability in the face of incompetent collateral structures or irreconcilable flexion-extension imbalances. However, little is known about its effect on overall knee range of motion (ROM). This study determines whether TKA with increased constraint affects postoperative ROM.

METHODS

Patients undergoing primary TKA using either posterior stabilized (PS) or constrained condylar knee (CCK) inserts were match-paired based on body mass index, preoperative ROM, and direction and severity of the coronal deformity, yielding 68 pairs. ROM and Knee Society Score (KSS) were obtained preoperatively and at 6 weeks, 4 months, and 1 year.

RESULTS

When the 68 matched pairs were considered, all outcome variables related to ROM between the PS and CCK groups at each of the postoperative intervals were similar. Additionally, both the individual items and combined scores of the KSS were similar between groups at all time points.

CONCLUSIONS

We demonstrate that the use of increased constraint does not affect ROM, relief of pain, or function after TKA.

LEVEL OF EVIDENCE

Level III (retrospective case-controlled study, based on prospectively collected data).

摘要

背景

在侧副韧带结构功能不全或屈伸不平衡无法纠正的情况下,限制性初次全膝关节置换术(TKA)可提供稳定性。然而,其对膝关节总体活动范围(ROM)的影响却知之甚少。本研究旨在确定增加限制性的TKA是否会影响术后ROM。

方法

采用后稳定型(PS)或限制性髁型膝关节(CCK)假体进行初次TKA的患者,根据体重指数、术前ROM以及冠状面畸形的方向和严重程度进行匹配配对,共得到68对。术前、术后6周、4个月和1年时测量ROM和膝关节协会评分(KSS)。

结果

在考虑这68对匹配患者时,PS组和CCK组在术后各时间点与ROM相关的所有结局变量均相似。此外,两组在所有时间点的KSS单项指标和综合评分也相似。

结论

我们证明,增加限制性的假体使用并不影响TKA术后的ROM、疼痛缓解或功能。

证据级别

III级(回顾性病例对照研究,基于前瞻性收集的数据)

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