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严重冠状面不稳定患者初次及翻修髁限制型全膝关节置换术的十年结果

Ten-Year Results of Primary and Revision Condylar-Constrained Total Knee Arthroplasty in Patients with Severe Coronal Plane Instability.

作者信息

Camera Andrea, Biggi Stefano, Cattaneo Gabriele, Brusaferri Giovanni

机构信息

Department of Prosthetic Surgery, Santa Corona Hospital, via XXV Aprile 38, 17027 Pietra Ligure (SV), Italy.

Clinical Affairs Department, Zimmer GmbH, Winterthur, Switzerland.

出版信息

Open Orthop J. 2015 Aug 31;9:379-89. doi: 10.2174/1874325001509010379. eCollection 2015.

Abstract

OBJECTIVE

To retrospectively review the results at minimum ten years after surgery of a consecutive series of total knee arthroplasties (TKAs) performed using a constrained condylar implant in patients with severe coronal plane instability.

MATERIALS AND METHODS

The series comprised of 44 patients (45 knees) who received primary (19 knees) or revision (26 knees) TKA with a constrained condylar implant between 2001 and 2003 at a single institution.

RESULTS

There were no revisions or any other surgery related complications at a mean implantation time of 11.0 years. In 38 patients (15 knees in the primary group and 24 knees in the revision group) who were available for clinico-radiographic follow-up at a minimum of ten years, there was no sign of radiographic loosening. Two patients showed cortical hypertrophy at the extension stem tip but none complained of pain around the stem tip. According to the TLKSS score grading, 73% of the patients in the primary group had results categorized as good or excellent, while 54% of the patients in the revision group had fair results. Four patients (one (7%) in the primary group and three (13%) in the revision group) had poor results. The median WOMAC Index was 80.2% (interquartile range: 74.0% - 81.2%) and 74.0% (interquartile range: 72.1% - 75.8%) in the primary and in the revision groups, respectively (p=0.010).

CONCLUSION

This study showed satisfactory clinical outcomes with no re-operations at minimum ten years after implantation in patients who had undergone primary or revision TKA with a condylar constrained implant.

摘要

目的

回顾性分析一系列使用限制性髁假体对严重冠状面不稳患者行全膝关节置换术(TKA)后至少十年的手术结果。

材料与方法

该系列研究纳入了2001年至2003年在单一机构接受初次(19膝)或翻修(26膝)TKA并使用限制性髁假体的44例患者(45膝)。

结果

平均植入时间为11.0年时,无翻修或任何其他与手术相关的并发症。在38例患者(初次手术组15膝,翻修手术组24膝)中,可进行至少十年的临床影像学随访,无影像学松动迹象。2例患者在延长柄末端出现皮质肥大,但均无柄末端周围疼痛主诉。根据TLKSS评分分级,初次手术组73%的患者结果为良好或优秀,而翻修手术组54%的患者结果为中等。4例患者(初次手术组1例(7%),翻修手术组3例(13%))结果较差。初次手术组和翻修手术组的WOMAC指数中位数分别为80.2%(四分位间距:74.0% - 81.2%)和74.0%(四分位间距:72.1% - 75.8%)(p = 0.010)。

结论

本研究表明,对于接受初次或翻修TKA并使用限制性髁假体植入的患者,在植入后至少十年时临床结果令人满意,无需再次手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6b1/4578137/2c0e7a1bfe28/TOORTHJ-9-379_F1.jpg

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