全膝关节置换翻修术后失败的预测因素。
Predictive factors for failure after total knee replacement revision.
机构信息
Department of Orthopaedics, Hospital Clinico San Carlos, Madrid, Spain,
出版信息
Int Orthop. 2014 Feb;38(2):429-35. doi: 10.1007/s00264-013-2268-8. Epub 2014 Jan 9.
PURPOSE
We used the Optetrak Condylar Constrained (CCK) implant, a modular and constrained knee implant as replacement for a failed primary arthroplasty, to assess the survivorship, the complications, the clinical, radiological, and functional situation, and the quality of life of those patients in whom a CCK had been implanted in recent years in order to find predictive pre-operative conditions of survival and clinical outcomes.
METHODS
We performed a retrospective study of 125 CCK implanted between 1999 and 2005. The mean follow-up was nine years (range, seven to 13). Mean age was 73.6 years. A total of 78% of the revised TKA were cemented and 66% were CR. We assessed the pre-operative, the operative and the postoperative conditions studying the medical files of all the patients. In order to study the functional and clinical situation we used the Hospital for Special Surgery (HSS) score and the Knee Society score (KSS), both clinical and functional. We analysed all the X-rays using the Knee Society Roentgenographic evaluation. The quality of life was studied using the Oxford knee score (OKS).
RESULTS
The mean results of the KSS clinical and the KSS functional were 68.24 and 63.85, respectively. There were not any conditions associated with poor results of the knees (p > 0.05). The global survival at 24 months was 92.7%, at 60 months 87.8% and at 96 months it was 87.8%. There were some conditions associated with poor survival of the knees, e.g. patients were younger than 70 years old, rheumatic diseases, kidney faliure, tibial tuberosity osteotomy, PS primary arthroplasty, revision before five years and septic loosening.
CONCLUSIONS
Based on these results there are some pre-operative factors that change the survival of the total knee replacement revision.
目的
我们使用 Optetrak Condylar Constrained（CCK）植入物，一种模块化和约束性膝关节植入物，作为初次关节置换失败的替代品，评估在最近几年中植入 CCK 的患者的生存率、并发症、临床、放射学和功能状况以及生活质量，以寻找与生存和临床结果相关的术前预测条件。
方法
我们对 1999 年至 2005 年间植入的 125 例 CCK 进行了回顾性研究。平均随访时间为 9 年（7 至 13 年）。平均年龄为 73.6 岁。总共 78%的翻修 TKA 是骨水泥固定的，66%是 CR。我们通过研究所有患者的病历，评估术前、术中和术后情况。为了研究功能和临床情况，我们使用了矫形外科医院（HSS）评分和膝关节协会评分（KSS），包括临床和功能评分。我们使用膝关节协会 X 线评估来分析所有 X 光片。使用牛津膝关节评分（OKS）来评估生活质量。
结果
KSS 临床和 KSS 功能的平均结果分别为 68.24 和 63.85。没有任何与膝关节结果不良相关的条件（p>0.05）。24 个月时的总体生存率为 92.7%，60 个月时为 87.8%，96 个月时为 87.8%。有一些与膝关节生存率不良相关的条件，例如患者年龄小于 70 岁、风湿性疾病、肾衰竭、胫骨结节截骨术、PS 初次置换、5 年内翻修和感染性松动。
结论
根据这些结果，有一些术前因素会改变全膝关节置换翻修的生存率。
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