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伦琴体视摄影分析:全聚乙烯单髁膝关节置换术后预测植体存活的有效工具——一项 10 年随访研究。

Roentgen stereophotogrammetric analysis: an effective tool to predict implant survival after an all-poly unicompartmental knee arthroplasty-a 10 year follow-up study.

机构信息

Biomechanics and Technological Innovation Laboratory, Codivilla-Putti Research Center, Rizzoli Orthopaedic Institute, Bologna University, Via Di Barbiano 1-10, 40136, Bologna, Italy.

Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), Univeristà di Bologna, Bologna, Italy.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Nov;23(11):3273-80. doi: 10.1007/s00167-014-3106-2. Epub 2014 Jun 11.

Abstract

PURPOSE

The main purpose of the present study was to determine long-term implant fixation of 15 unicompartmental knee arthroplasty (UKAs) with an all-poly tibial component using Roentgen stereophotogrammetric analysis (RSA) at a mean 10-year follow-up. The secondary purpose was to investigate whether the progressive loss of implant's fixation correlates with a reduction in Knee society score (KSS).

METHODS

Fifteen non-consecutive patients with primary knee osteoarthritis received a UKA with an all-poly tibial component were assessed using KSS scores pre-operatively and post-operatively and RSA on day 2 after surgery, then at 3, 6, and 12 months and yearly thereafter. The mean last follow-up was 10 years.

RESULTS

An increase in maximum total point motion (MTPM) values from 6 months to 1 year post-operatively was found respect to post-operative reference. Implants' displacement values were always <2 mm during the first 6 months, and then, two different trends were noticed in revised and non-revised implants. MTPM increase between 1 and 2 years of follow-up in non-revised UKAs was always <0.2 mm, whereas it was >0.2 mm in revised UKAs. A linear and negative correlation with statistical significance was found between MTPM and both clinical and functional KSS scores (p < 0.001).

CONCLUSION

Also in a long-term follow-up evaluation, RSA is an effective tool to predict functional results after an all-poly UKA providing also a relevant predictive value at 1 year follow-up, and this can be very useful for both patients and surgeons.

LEVEL OF EVIDENCE

Diagnostic studies, Level III.

摘要

目的

本研究的主要目的是通过使用放射性立体摄影分析(RSA)在平均 10 年随访时确定 15 例全聚乙烯胫骨组件单髁膝关节置换术(UKA)的长期植入物固定。次要目的是研究植入物固定的逐渐丧失是否与膝关节协会评分(KSS)的降低相关。

方法

15 例原发性膝关节骨关节炎患者接受了全聚乙烯胫骨组件的 UKA,使用 KSS 评分在术前和术后进行评估,并在术后第 2 天、术后 3、6、12 个月和此后每年进行 RSA。平均最后一次随访时间为 10 年。

结果

与术后参考相比,术后 6 个月至 1 年时最大总点运动(MTPM)值增加。在最初的 6 个月内,植入物的位移值始终<2 毫米,然后在修订和未修订的植入物中注意到两种不同的趋势。在未修订的 UKA 中,1 至 2 年随访期间 MTPM 的增加始终<0.2 毫米,而在修订的 UKA 中则>0.2 毫米。MTPM 与临床和功能 KSS 评分之间存在线性和具有统计学意义的负相关(p<0.001)。

结论

即使在长期随访评估中,RSA 也是一种有效的工具,可以预测全聚乙烯 UKA 后的功能结果,并且在 1 年随访时还具有重要的预测价值,这对患者和外科医生都非常有用。

证据水平

诊断研究,III 级。

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