Goetz Juergen, Schiessl Susanne, Baier Clemens, Dullien Silvia, Mueller Karolina, Grifka Joachim, Koeck Franz
Orthopaedic Department, University Hospital Regensburg, Regensburg, Germany.
Asklepios Klinikum Bad Abbach, Medical Centre University of Regensburg, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany.
Int Orthop. 2017 Jan;41(1):67-73. doi: 10.1007/s00264-016-3266-4. Epub 2016 Sep 6.
Total knee arthroplasty provides excellent results concerning functional demands, patient satisfaction and range of motion. Short-term results after implantation of patient-specific knee spacers also show encouraging results. We hypothesised that patient-specific interpositional devices provide better proprioception and postural stability by preserving the whole bone stock and both cruciate ligaments.
In this study we compared functional results, proprioception and postural stability 16 months after 20 consecutive patient-specific interpositional device implantations of the knee (group A) and 20 consecutive total knee arthroplasties (group B). Patients were evaluated using the Knee Society Score (KSS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Postural stability was analysed during single leg stance on a force platform (Biodex).
There were no significant differences between both groups concerning functional results 16 months after the procedure. Concerning postural stability, significant differences were found between both groups. Comparing the operated-on and non-operated-on sides in single leg stance, the operated-on leg gained the same stability as the non-operated-on side in both groups.
The successful treatment of knee osteoarthritis can restore postural stability to the level of the unaffected side-independent from the implanted devices and with preservation of soft tissue and bone stock. Superior postural stability in joint-preserving patient-specific interpositional knee devices compared with total knee arthroplasty had to be attributed to the different age of both groups.
全膝关节置换术在功能需求、患者满意度和活动范围方面取得了优异的效果。植入定制膝关节间隔器后的短期效果也令人鼓舞。我们假设定制的置入装置通过保留全部骨量和两条交叉韧带能提供更好的本体感觉和姿势稳定性。
在本研究中，我们比较了连续20例接受定制膝关节置入装置植入术的患者（A组）和连续20例行全膝关节置换术的患者（B组）术后16个月的功能结果、本体感觉和姿势稳定性。使用膝关节协会评分（KSS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）对患者进行评估。在测力平台（Biodex）上进行单腿站立时分析姿势稳定性。
术后16个月，两组在功能结果方面无显著差异。在姿势稳定性方面，两组之间存在显著差异。在单腿站立时比较手术侧和非手术侧，两组中手术侧获得的稳定性与非手术侧相同。
膝关节骨关节炎的成功治疗可将姿势稳定性恢复到未受影响侧的水平，与植入装置无关，且保留了软组织和骨量。与全膝关节置换术相比，保留关节的定制膝关节置入装置具有更好的姿势稳定性，这必须归因于两组患者的不同年龄。
