Delport H P
Department of Orthopaedic Surgery, AZ Nikolaas, SintNiklaas, Belgium.
Open Orthop J. 2013 Nov 15;7:635-40. doi: 10.2174/1874325001307010635. eCollection 2013.
The aim of total knee surgery is to provide patients with end-stage osteoarthritis of the knee with both pain relief and a functional range of motion with a securely fixed prosthesis for the long term. Many types of implants are designed to achieve these goals. Only clinical outcome studies are able to substantiate the superiority of one design over another. Our primary research question was to determine whether patients receiving a rotating platform implant had a better functional outcome.
A total of 1,152 Performance Total Knee Arthroplastiesin 943 patients were studied prospectively. In 561 cases, the cruciate retaining model (CR) was used. In 591 cases the cruciate substituting with posterior-stabilized model (PS) was implanted (324 cases with a fixed bearing (PSFB) and 267 cases with a rotating platform (PSRP)).
The Clinical KSS score was similar for the three types at 1, 5, 10 and 15 years post-operatively. The Functional score also remained similar for all types until 10 years; at 15 years functional results of the CR group decreased.
Neither clinically nor radiographically did the use of a rotating platform prove to be more advantageous than fixed bearing tibial components. Thus, the advantage of a Total Knee Arthroplasty with Rotating Platform remains theoretical.
全膝关节置换手术的目的是为终末期膝关节骨关节炎患者提供疼痛缓解、具有功能活动范围且假体长期牢固固定的效果。设计了多种类型的植入物来实现这些目标。只有临床结果研究才能证实一种设计相对于另一种设计的优越性。我们的主要研究问题是确定接受旋转平台植入物的患者是否具有更好的功能结果。
对943例患者的1152例全膝关节置换术进行了前瞻性研究。其中561例采用保留交叉韧带模型(CR)。591例植入后稳定型交叉韧带替代模型(PS)(324例采用固定平台(PSFB),267例采用旋转平台(PSRP))。
术后1年、5年、10年和15年,三种类型的临床KSS评分相似。直到10年,所有类型的功能评分也保持相似;15年时,CR组的功能结果下降。
无论是临床还是影像学方面,旋转平台的使用都没有被证明比固定平台胫骨组件更具优势。因此,旋转平台全膝关节置换术的优势仍停留在理论层面。