Fuchs Mathijs C H W, Janssen Rob P A
Orthopaedic Center Máxima, Postbox 90052, 5631 BM, Eindhoven, The Netherlands,
Eur J Orthop Surg Traumatol. 2015 Jan;25(1):161-6. doi: 10.1007/s00590-014-1467-3. Epub 2014 Jun 8.
The primary aim of the study was to evaluate the range of motion and complications after Genesis II total knee arthroplasty with high-flexion tibia insert (TKA-HF). Furthermore, difference in knee flexion between high flexion and standard inserts was compared. The hypothesis was that knee flexion is better after high-flexion TKA. A total of 292 TKA-HF were retrospectively reviewed. Mean follow-up was 24.3 months. The range of motion was compared between TKA-HF (high-flexion group) and a comparable cohort of 86 Genesis II TKA with a standard tibia insert (control group). Surgeries were performed by one experienced knee orthopedic surgeon. Knee flexion in the high-flexion group increased from 114.8° preoperatively to 118.0° postoperatively (P < 0.01). Knee extension in the high-flexion group increased from -4.5° preoperatively to -0.4° after surgery (P < 0.01). Mean knee flexion was 5.52° (± 1.46°) better in the high-flexion group compared with the control group (P < 0.01). Preoperative range of motion, body mass index, diabetes mellitus and patellofemoral pain significantly influenced range of motion. Few complications occurred after TKA-HF. The Genesis II TKA-HF showed good short-term results with limited complications. Knee flexion after Genesis II TKA-HF was better compared with a standard tibia insert.
本研究的主要目的是评估采用高屈曲胫骨假体的Genesis II全膝关节置换术（TKA-HF）后的活动范围及并发症。此外，还比较了高屈曲假体与标准假体之间膝关节屈曲度的差异。假设是高屈曲TKA术后膝关节屈曲情况更佳。对292例TKA-HF进行了回顾性研究。平均随访时间为24.3个月。比较了TKA-HF组（高屈曲组）与86例采用标准胫骨假体的Genesis II TKA的对照队列的活动范围。手术由一位经验丰富的膝关节骨科医生实施。高屈曲组的膝关节屈曲度从术前的114.8°增加至术后的118.0°（P < 0.01）。高屈曲组的膝关节伸展度从术前的-4.5°增加至术后的-0.4°（P < 0.01）。与对照组相比，高屈曲组的平均膝关节屈曲度要好5.52°（± 1.46°）（P < 0.01）。术前活动范围、体重指数、糖尿病及髌股关节疼痛对活动范围有显著影响。TKA-HF术后并发症较少。Genesis II TKA-HF显示出良好的短期效果，并发症有限。与标准胫骨假体相比，Genesis II TKA-HF术后膝关节屈曲情况更佳。
