447 例 SCORE® 高度一致型活动平台全膝关节置换术后 5-10 年随访结果。
Outcomes of 447 SCORE® highly congruent mobile-bearing total knee arthroplasties after 5-10 years follow-up.
机构信息
Clinique des Alpes, 31, rue A.-Dumas, 38100 Grenoble, France; Clinique Belledonne, avenue G.-Péri, 38240 Saint-Martin d'Hères, France.
出版信息
Orthop Traumatol Surg Res. 2013 Oct;99(6):681-6. doi: 10.1016/j.otsr.2013.05.003. Epub 2013 Aug 26.
INTRODUCTION
The goal of mobile-bearing total knee arthroplasties (TKA) with an anatomical trochlea is to reduce polyethylene wear, the risk of loosening, and patellofemoral complications. Rotating mobile-bearing SCORE(®) TKA was designed according to these principles with standard instrumentation for component placement and a specific computer navigation system, Amplivision(®).
HYPOTHESIS
We hypothesized that the results of SCORE(®) TKA would be satisfactory and better using computer navigation with or without patellar resurfacing and that there would be no specific patellofemoral complications associated with this trochlear design.
MATERIALS AND METHODS
Four hundred and forty-seven SCORE(®) TKA were performed. Outcome assessment was based on the IKS score, and component survival calculated by Kaplan-Meier analysis.
RESULTS
Mean follow-up was 6.6 years (maximum 10.6 years). Six percent of patients were lost to follow-up. Ninety-eight percent of the patients were satisfied or very satisfied. The IKS knee score was 89 points and the function score was 86. The mechanical axis was 180° (174-186), and it was significantly improved if the initial deformity was severe and TKA was computer navigated. There were nine revisions (one for fracture, two for pain, two for stiffness, four for infection).
DISCUSSION
This study confirmed our hypothesis: the results of SCORE(®) TKA were very satisfying after at least 5 years of follow-up because there was no mechanical loosening, no bearing dislocation and no patellofemoral complications with or without patellar resurfacing. Results were identical whether patellar resurfacing was performed or not. Although clinical results were not better for computer- navigated TKA, radiological results were. At 98 months of follow-up, component survival in relation to the risk of aseptic loosening or patellofemoral complications was 100%.
LEVEL OF EVIDENCE
Level IV continuous retrospective study.
简介
带解剖型滑车的活动平台全膝关节置换术（TKA）的目标是减少聚乙烯磨损、松动风险和髌股并发症。旋转活动平台 SCORE（®）TKA 是根据这些原则设计的，采用标准的组件放置器械和特定的计算机导航系统 Amplivision（®）。
假说
我们假设 SCORE（®）TKA 的结果在使用或不使用髌骨表面置换的计算机导航下是令人满意的，并且更好，并且与这种滑车设计相关的不会有特定的髌股并发症。
材料和方法
共进行了 447 例 SCORE（®）TKA。根据 IKS 评分和 Kaplan-Meier 分析计算的组件存活率进行结果评估。
结果
平均随访时间为 6.6 年（最长 10.6 年）。有 6%的患者失访。98%的患者满意或非常满意。IKS 膝关节评分 89 分，功能评分 86 分。机械轴为 180°（174-186），如果初始畸形严重且 TKA 为计算机导航，则明显改善。有 9 例翻修（1 例骨折，2 例疼痛，2 例僵硬，4 例感染）。
讨论
本研究证实了我们的假设：在至少 5 年的随访后，SCORE（®）TKA 的结果非常令人满意，因为无论是否进行髌骨表面置换，都没有机械松动、没有轴承脱位，也没有髌股并发症。是否进行髌骨表面置换，结果是相同的。尽管计算机导航 TKA 的临床结果没有更好，但影像学结果是。在 98 个月的随访中，与无菌性松动或髌股并发症风险相关的组件存活率为 100%。
证据水平
四级连续回顾性研究。
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