Bae Dae Kyung, Cho Sung Do, Im Sang Kyu, Song Sang Jun
Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
J Arthroplasty. 2016 Feb;31(2):419-24. doi: 10.1016/j.arth.2015.09.038. Epub 2015 Sep 28.
Despite the theoretical advantage of a knee design that can more reliably replicate the medial pivot (MP) of the natural knee, only a few clinical studies have compared the clinical results between the MP prosthesis and another design of prosthesis. We compared the midterm results of total knee arthroplasty (TKA) using an MP prosthesis vs a posterior-stabilized prosthesis via a matched-pair analysis; we included results related to patellofemoral joint symptoms.
The midterm clinical and radiographic results of 125 consecutive patients (150 knees) who underwent a TKA with the ADVANCE MP prosthesis were compared with those of a control group who had undergone a primary TKA with a posterior-stabilized prosthesis.
Values of the Knee Society's Knee Scoring System, Western Ontario and McMaster Universities Osteoarthritis Index, and Kujala and Feller scoring systems, as well as the range of motion after TKA, did not significantly differ between the 2 groups. No differences in femorotibial angle and component position, including the patella component, were observed between the 2 groups. No significant differences in the change of patella tilt angle and the postoperative patellar translation were observed between the 2 groups.
Patients with the MP prosthesis experienced satisfactory pain relief and a functional recovery, providing results similar to those of the posterior-stabilized prosthesis, including the resolution of patellofemoral joint symptoms.
尽管膝关节设计在理论上具有优势,能够更可靠地复制自然膝关节的内侧旋转(MP),但仅有少数临床研究比较了MP假体与其他假体设计的临床结果。我们通过配对分析比较了使用MP假体与后稳定型假体进行全膝关节置换术(TKA)的中期结果;我们纳入了与髌股关节症状相关的结果。
将连续125例(150膝)接受ADVANCE MP假体TKA患者的中期临床及影像学结果,与接受初次后稳定型假体TKA的对照组患者的结果进行比较。
两组之间,膝关节协会膝关节评分系统、西安大略和麦克马斯特大学骨关节炎指数、库亚拉和费勒评分系统的值,以及TKA后的活动范围,均无显著差异。两组之间在股胫角和假体位置(包括髌骨假体)方面未观察到差异。两组之间在髌骨倾斜角变化和术后髌骨移位方面未观察到显著差异。
使用MP假体的患者疼痛缓解和功能恢复情况良好,其结果与后稳定型假体相似,包括髌股关节症状的缓解。