两种不同三组件全踝关节置换系统矢状位半脱位的比较。
Comparison of sagittal subluxation in two different three-component total ankle replacement systems.
机构信息
Foot and Ankle Clinic, KT Lee's Orthopedic Hospital, Seoul, Republic of Korea.
出版信息
Foot Ankle Int. 2013 Dec;34(12):1661-8. doi: 10.1177/1071100713505752. Epub 2013 Sep 24.
BACKGROUND
Malalignment following total ankle arthroplasty (TAA) has been reported in 4% to 45% of patients. However, all reports to date have been related to coronal deformity. This study compared sagittal malalignment between the Mobility and Hintegra total ankle systems and assessed the positional stability of the implant components over time.
METHODS
The study included 50 cases each of total ankle replacement arthroplasty with the Hintegra and Mobility total ankle systems performed between May 2008 and June 2010. The Mobility group included 24 men and 25 women, and the mean age was 60.3 years (range, 50.7-70.0 years). The Hintegra group included 25 men and 25 women, and the mean age was 59.8 years (range, 50.8-68.7 years). The 2 groups did not differ in terms of gender (P = .76) or age (P = .77). Three independent observers with different levels of training evaluated the radiographs and performed the measurements independently. Each observer evaluated the radiographs twice at a 6-week interval to determine the intraobserver reliability, and the anteroposterior offset ratio was evaluated.
RESULTS
The anteroposterior offset ratio intra- and interobserver reliabilities all showed good or excellent levels of agreement in the Hintegra total ankle system and the Mobility total ankle system. With respect to the stability of sagittal translation of the talus, the Mobility system (0.08 ± 0.07 immediately, 0.0 ± 0.07 at 6 weeks postoperatively, and 0.01 ± 0.07 at 1 year postoperatively) was better than the Hintegra system (0.20 ± 0.08 immediately, 0.18 ± 0.11 at 6 weeks postoperatively, and 0.15 ± 0.10 at 1 year postoperatively) (P < .0001).
CONCLUSIONS
The Mobility system had less sagittal malalignment of the talus than the Hintegra system. Consequently, when treating ankles in patients with osteoarthritis using the Hintegra system, one must pay careful attention to sagittal malalignment during surgery.
LEVEL OF EVIDENCE
Level III, retrospective comparative series.
背景
全踝关节置换术后（TAA）的对线不良已在 4%至 45%的患者中报告。然而，迄今为止所有报告都与冠状面畸形有关。本研究比较了 Mobility 和 Hintegra 全踝关节系统的矢状面对线，并评估了植入物组件随时间的位置稳定性。
方法
该研究纳入了 2008 年 5 月至 2010 年 6 月期间行全踝关节置换术的 Mobility 和 Hintegra 全踝关节系统各 50 例。 Mobility 组包括 24 例男性和 25 例女性，平均年龄为 60.3 岁（范围 50.7-70.0 岁）。Hintegra 组包括 25 例男性和 25 例女性，平均年龄为 59.8 岁（范围 50.8-68.7 岁）。两组在性别（P =.76）或年龄（P =.77）方面无差异。3 名具有不同培训水平的独立观察者独立评估了 X 线片并进行了测量。每位观察者在 6 周的间隔内评估了 X 线片两次，以确定观察者内的可靠性，并评估了前后偏移比。
结果
Hintegra 全踝关节系统和 Mobility 全踝关节系统的前后偏移比观察者内和观察者间的可靠性均显示出良好或极好的一致性。就距骨矢状面平移的稳定性而言，Mobility 系统（立即为 0.08±0.07，术后 6 周时为 0.0±0.07，术后 1 年时为 0.01±0.07）优于 Hintegra 系统（立即为 0.20±0.08，术后 6 周时为 0.18±0.11，术后 1 年时为 0.15±0.10）（P<0.0001）。
结论
Mobility 系统的距骨矢状面对线不良较 Hintegra 系统少。因此，在使用 Hintegra 系统治疗骨关节炎患者的踝关节时，在手术中必须注意矢状面对线不良。
证据水平
III 级，回顾性比较系列。
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