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使用带有保留交叉韧带和超匹配膝关节插入物的Persona膝关节系统进行全膝关节置换术后的步态参数和功能结果

Gait Parameters and Functional Outcomes After Total Knee Arthroplasty Using Persona Knee System With Cruciate Retaining and Ultracongruent Knee Inserts.

作者信息

Rajgopal Ashok, Aggarwal Kalpana, Khurana Anshika, Rao Arun, Vasdev Attique, Pandit Hemant

机构信息

Medanta Bone and Joint Institute, Medanta-The Medicity, Gurgaon, Haryana, India.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.

出版信息

J Arthroplasty. 2017 Jan;32(1):87-91. doi: 10.1016/j.arth.2016.06.012. Epub 2016 Jun 23.

Abstract

BACKGROUND

Total knee arthroplasty is a well-established treatment for managing end-stage symptomatic knee osteoarthritis. Currently, different designs of prostheses are available with majority ensuring similar clinical outcomes. Altered surface geometry is introduced to strive toward gaining superior outcomes. We aimed to investigate any differences in functional outcomes between 2 different polyethylene designs namely the Persona CR (cruciate retaining) and Persona UC (ultracongruent) tibial inserts (Zimmer-Biomet, Warsaw, IN).

METHODS

This prospective single blind, single-surgeon randomized controlled trial reports on 105 patients, (66 female and 39 male), who underwent simultaneous bilateral total knee arthroplasty using the Persona knee system (Zimmer-Biomet) UC inserts in one side and CR inserts in the contralateral side. By a blind assessor, at regular time intervals patients were assessed in terms of function and gait. The functional knee scoring scales used were the Western Ontario and McMaster Universities Osteoarthritis Index and Modified Knee Society Score. The gait parameters evaluated were foot pressure and step length.

RESULTS

During the study period, no patient was lost to follow-up or underwent revision surgery for any cause. Western Ontario and McMaster Universities Osteoarthritis Index scores, Modified Knee Society Score, and knee range of motion of all 105 patients assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years showed statistically better results (P < .05) for UC inserts. Gait analysis measuring foot pressures and step length, however, did not show any statistically significant differences at 2-year follow-up.

CONCLUSION

Ultracongruent tibial inserts show significantly better functional outcomes as compared to CR inserts during a 2-year follow-up period. However, in this study these findings were not shown to be attributed to differences in gait parameters.

摘要

背景

全膝关节置换术是治疗终末期有症状的膝关节骨关节炎的一种成熟疗法。目前,有多种不同设计的假体可供选择,大多数假体都能确保相似的临床效果。引入改变的表面几何形状以争取获得更好的效果。我们旨在研究两种不同聚乙烯设计的假体,即Persona CR(保留交叉韧带)和Persona UC(超匹配)胫骨衬垫(捷迈邦美公司,印第安纳州华沙)在功能结果上的差异。

方法

这项前瞻性单盲、单术者随机对照试验报告了105例患者(66例女性和39例男性),他们使用Persona膝关节系统(捷迈邦美公司),一侧植入UC衬垫,对侧植入CR衬垫,同时进行双侧全膝关节置换术。由一名盲法评估者在定期时间间隔对患者的功能和步态进行评估。使用的功能膝关节评分量表是西安大略和麦克马斯特大学骨关节炎指数以及改良膝关节协会评分。评估的步态参数是足部压力和步长。

结果

在研究期间,没有患者失访或因任何原因接受翻修手术。对所有105例患者术前以及术后6个月、1年和2年进行评估,结果显示,UC衬垫在西安大略和麦克马斯特大学骨关节炎指数评分、改良膝关节协会评分以及膝关节活动范围方面有统计学上更好的结果(P < 0.05)。然而,在2年随访时,测量足部压力和步长的步态分析未显示任何统计学上的显著差异。

结论

在2年随访期内,超匹配胫骨衬垫的功能结果明显优于CR衬垫。然而,在本研究中,这些结果并未显示归因于步态参数的差异。

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