Saleh Hesham, Yu Stephen, Vigdorchik Jonathan, Schwarzkopf Ran
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf, Division of Adult Reconstruction, Department of Orthoapedic Surgery, New York University Langone Medical Center, Hospital for Joint Diseases, New York, NY 10003, United States.
World J Orthop. 2016 Sep 18;7(9):584-91. doi: 10.5312/wjo.v7.i9.584.
To review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA).
We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles. We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.
Sixteen studies, four prospective and ten retrospective, examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion (ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.
Although associated with higher complication rates, TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.
回顾并报告全膝关节置换术（TKA）治疗创伤后关节炎（PTA）的功能结局、并发症及假体生存率。
我们按照PRISMA指南进行了系统评价。2015年12月，我们在PubMed、Cochrane图书馆和SCOPUS中检索了英文临床研究，包括前瞻性和回顾性研究，以考察TKA治疗PTA的应用情况。获取了所有相关文章的全文。手工检索包括检索到文章的参考文献。我们提取了患者的人口统计学数据和临床结局，包括术前诊断以及术前和术后的功能评分。我们汇总了数据，并以表格和文字形式报告了结果。
16项研究，4项前瞻性研究和10项回顾性研究，考察了因胫骨近端、髌骨和/或股骨远端骨折而接受TKA治疗PTA的患者。11项研究采用膝关节协会评分标准评估功能结局。所有采用这些标准的研究均报告TKA术后患者的功能和膝关节评分有所改善。此外，研究报告术后活动范围（ROM）增加且疼痛减轻。TKA最常报告的并发症包括感染、僵硬、伤口并发症、术中肌腱断裂以及骨溶解/聚乙烯磨损。这些并发症绝大多数发生在术后头两年内。6项研究将TKA随后因任何原因进行翻修作为终点考察了假体生存率。与骨关节炎患者相比，PTA患者需要更多的翻修，大多数是因为聚乙烯磨损。
尽管TKA的并发症发生率较高，但它是治疗PTA的有效方法，因为它能改善ROM、疼痛和功能结局。
