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保留或不保留后交叉韧带的EUROP全膝关节假体?中期随访的比较研究。

EUROP total knee prosthesis with or without posterior cruciate ligament retention? Comparative study at mid-term follow-up.

作者信息

Mouttet A, Sourdet V

机构信息

Clinique Saint-Roch, chemin du Mas-Anglade, 66330 Cabestany, France.

Département Scientifique, EUROS SAS, ZE Athélia III, 13600 La Ciotat, France.

出版信息

Orthop Traumatol Surg Res. 2014 Dec;100(8):895-900. doi: 10.1016/j.otsr.2014.05.023. Epub 2014 Nov 20.

Abstract

INTRODUCTION

The aim of the present study was to compare mid-term clinical and functional results of two fixed-bearing EUROP total knee arthroplasties (TKA) with the same design, one in which the posterior cruciate ligament was retained (CR) and the other with posterior-stabilization (PS).

HYPOTHESIS

Mid-term results are similar.

MATERIALS AND METHODS

In this prospective, single centre, comparative study, 104 patients (mean age 76) received 114 cemented fixed-bearing posterior cruciate-retaining or posterior-stabilized EUROP TKA. Only patients in whom the medial pivot and ligaments were intact received a CR prosthesis. The final decision to retain or not the posterior cruciate ligament was made if the flexion gap was well balanced above 90°. Clinical evaluation was performed using the International Knee Society (IKS) score at a mean follow-up of 54 months.

RESULTS

The preoperative IKS function score improved from 30 points in both groups, to 75 points in the CR group and to 65 points in the PS group postoperatively. The preoperative IKS knee score improved from 29 and 25 points in the CR and PS groups, respectively, to 87 points in both groups postoperatively. There was no significant difference in the pre- or postoperative scores between the two groups. Four prostheses underwent surgical revision, three CR and one PS. With revision for any reason as the end point, seven-year overall implant survival was 94.8% in the CR group and 97.5% in the PS group. There was no significant difference between the CR and PS groups.

DISCUSSION

When the indications were followed, our study shows similar mid-term results for both types of TKA.

LEVEL OF EVIDENCE

Level IV, prospective study.

摘要

引言

本研究旨在比较两种设计相同的固定平台EUROP全膝关节置换术(TKA)的中期临床和功能结果,一种保留后交叉韧带(CR),另一种采用后稳定型(PS)。

假设

中期结果相似。

材料与方法

在这项前瞻性、单中心的比较研究中,104例患者(平均年龄76岁)接受了114例骨水泥固定平台保留后交叉韧带或后稳定型EUROP TKA。只有内侧旋转平台和韧带完整的患者接受CR假体。如果屈膝间隙在90°以上平衡良好,则最终决定是否保留后交叉韧带。平均随访54个月时,使用国际膝关节协会(IKS)评分进行临床评估。

结果

两组术前IKS功能评分均为30分,术后CR组提高到75分,PS组提高到65分。CR组和PS组术前IKS膝关节评分分别为29分和25分,术后两组均提高到87分。两组术前和术后评分无显著差异。4例假体进行了手术翻修,3例CR型和1例PS型。以任何原因翻修为终点,CR组7年假体总生存率为94.8%,PS组为97.5%。CR组和PS组之间无显著差异。

讨论

按照适应证选择患者时,我们的研究表明两种类型的TKA中期结果相似。

证据水平

IV级,前瞻性研究。

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