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根据机械轴偏差的旋转平台全膝关节置换术的时间依赖性临床结果。

Time-dependent clinical results of rotating-platform total knee arthroplasty according to mechanical axis deviation.

作者信息

Lee Han-Jun, Jung Ho-Joong, Jung Young-Bok, Ko Young-Bong, Song Min-Ku, Kim Seong-Hwan

机构信息

Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul, Korea.

出版信息

Knee Surg Relat Res. 2014 Sep;26(3):141-8. doi: 10.5792/ksrr.2014.26.3.141. Epub 2014 Aug 29.

Abstract

PURPOSE

We hypothesized that the low contact stress (LCS) posterior stabilization system in knees with ≤3° deviation of coronal alignment would provide more favorable clinical outcomes and survival rate over the course of time.

MATERIALS AND METHODS

A retrospective study was performed on 253 consecutive cases of primary total knee arthroplasty (TKA). Patients were classified according to the degree of deviation of coronal alignment on the initial postoperative radiograph as Group 1 (≤3° deviation) and Group 2 (>3° deviation). The clinical assessments were performed using the Knee Society score and Hospital for Special Surgery systems and Western Ontario and McMaster Universities index.

RESULTS

The survival rate was 97.4% in Group 1 and 96.8% in Group 2. No statistically significant intergroup difference was observed in the clinical scores before surgery and since 1 year after surgery (p>0.05). However, a significant intergroup difference was noted between 6 months to 1 year after surgery (p<0.001). Less than 2 mm radiolucent lines were found more frequently in Group 2. Time-dependent improvement was noted within one year after TKA in both groups.

CONCLUSIONS

Most of the expected improvements were achieved at 6 months after surgery in Group 1 and at 1 year after surgery in Group 2. The present study suggests that the LCS system yields time-dependent improvement regardless of coronal alignment deviation.

摘要

目的

我们假设在冠状位对线偏差≤3°的膝关节中,低接触应力(LCS)后稳定系统随着时间推移将提供更有利的临床结果和生存率。

材料与方法

对253例连续的初次全膝关节置换术(TKA)病例进行回顾性研究。根据术后初始X线片上冠状位对线偏差程度将患者分为1组(偏差≤3°)和2组(偏差>3°)。使用膝关节协会评分、特种外科医院系统以及西安大略和麦克马斯特大学指数进行临床评估。

结果

1组的生存率为97.4%,2组为96.8%。术前及术后1年的临床评分在组间未观察到统计学显著差异(p>0.05)。然而,术后6个月至1年组间存在显著差异(p<0.001)。2组中发现小于2mm的透亮线更为频繁。两组在TKA术后1年内均出现随时间的改善。

结论

1组在术后6个月、2组在术后1年实现了大部分预期的改善。本研究表明,无论冠状位对线偏差如何,LCS系统都会随时间产生改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a43b/4163571/9254a98eec17/ksrr-26-141-g001.jpg

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