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超全等移动和固定平台导航辅助全膝关节置换术的比较:至少5年随访

Comparison of ultra-congruent mobile- and fixed-bearing navigation-assisted total knee arthroplasty with minimum 5-year follow-up.

作者信息

Kim Seong Hwan, Lim Jung-Won, Ko Young-Bong, Song Min-Gu, Lee Han-Jun

机构信息

Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-ku, Seoul, 156-755, South Korea.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3466-3473. doi: 10.1007/s00167-016-4147-5. Epub 2016 May 4.

Abstract

PURPOSE

The purpose of this study was to compare the midterm outcomes between fixed and mobile ultra-congruent (UC) bearings in total knee arthroplasty (TKA).

METHODS

This is a retrospective matched-pairs case-control study of patients who underwent primary navigation-assisted TKA with a minimum 5-year follow-up. A total of 182 cases involved the fixed UC bearing system as Group 1 and 101 cases involved mobile UC bearing system group as Group 2. After 1:1 matching, 73 knees in each group were enrolled. Clinical and radiographic outcomes were evaluated.

RESULTS

The overall survival was 143 of 146 cases (97.9 %) at final follow-up, and 72 of 73 cases (96.3 %) in Group 1 and 71 of 73 cases (95.8 %) in Group 2 at final follow-up based on an endpoint of revision surgery. The reasons of revision TKA were periprosthetic fracture in Group 1, infection and bearing dislocation in Group 2. There was no statistical difference in Hospital for Special Surgery (HSS) scores, Knee Society Scores (KSS), WOMAC index score evaluations between groups.

CONCLUSIONS

This study demonstrated that the fixed-bearing UC prosthesis could provide satisfactory performance compared with that of the mobile-bearing UC prosthesis with minimum 5-year follow-up. The fixed-bearing UC prosthesis could be considered in navigation-assisted TKA with theoretical advantages of UC design.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在比较全膝关节置换术(TKA)中固定和活动超匹配(UC)衬垫的中期疗效。

方法

这是一项回顾性配对病例对照研究,研究对象为接受初次导航辅助TKA且至少随访5年的患者。共有182例患者使用固定UC衬垫系统作为第1组,101例患者使用活动UC衬垫系统作为第2组。经过1:1配对后,每组纳入73例膝关节。评估临床和影像学结果。

结果

末次随访时,146例患者中有143例(97.9%)总体存活,基于翻修手术终点,第1组73例中有72例(96.3%),第2组73例中有71例(95.8%)。第1组翻修TKA的原因是假体周围骨折,第2组是感染和衬垫脱位。两组之间在特种外科医院(HSS)评分、膝关节协会评分(KSS)、WOMAC指数评分评估方面无统计学差异。

结论

本研究表明,在至少5年的随访中,与活动衬垫UC假体相比,固定衬垫UC假体可提供令人满意的性能。在导航辅助TKA中可考虑使用固定衬垫UC假体,其具有UC设计的理论优势。

证据级别

IV级。

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