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GENESIS II全膝关节置换术至少15年的临床结果及假体生存率

Clinical Results and Survivorship of the GENESIS II Total Knee Arthroplasty at a Minimum of 15 Years.

作者信息

McCalden Richard W, Hart Gavin P, MacDonald Steven J, Naudie Douglas D, Howard James H, Bourne Robert B

机构信息

Division of Orthopaedic Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.

出版信息

J Arthroplasty. 2017 Jul;32(7):2161-2166. doi: 10.1016/j.arth.2017.02.006. Epub 2017 Feb 16.

DOI:10.1016/j.arth.2017.02.006
PMID:28285899
Abstract

BACKGROUND

The purpose of this study was to examine the 15-year survivorship and long-term clinical outcomes of the GENESIS II total knee arthroplasty (TKA).

METHODS

Patients who underwent TKA with the GENESIS II system between 1995 and 1999 were retrieved from our institutional database. We report a Kaplan-Meier survival analysis as well as Western Ontario and McMaster Universities Arthritis Index, the Short Form Health Survey-12 (SF-12), and the Knee Society Scores at a mean of 16 years.

RESULTS

Four-hundred sixty-nine TKAs were performed with a mean patient age of 68 years. Patients were followed up prospectively for a mean of 16 years (range, 14.8-19.5 years). The Kaplan-Meier survival analysis at 15 years, with revision for any reason as the end point, was 96.4% (95.5%-97.3%). The Western Ontario and McMaster Universities Arthritis Index and the Knee Society Scores were significantly improved (P < .001) from the preoperative period to the latest follow-up. Patients had a significant improvement (P < .001) from the preoperative to the latest follow-up on the Physical Health Composite Score of the SF-12, but no change was noted on the Mental Health Composite Score of the SF-12.

CONCLUSION

The unique design features of the GENESIS II TKA system have remained a constant over the duration of its clinical use, a rarity for contemporary TKA systems which are often altered before the publication of long-term results. The GENESIS II continues to demonstrate excellent long-term survivorship and improvements in health-related outcomes at a mean of 15 years, representing the standard for TKA systems at our institution.

摘要

背景

本研究旨在探讨GENESIS II全膝关节置换术(TKA)的15年生存率及长期临床疗效。

方法

从我们机构的数据库中检索出1995年至1999年间接受GENESIS II系统TKA的患者。我们报告了Kaplan-Meier生存分析以及平均16年时的西安大略和麦克马斯特大学关节炎指数、简短健康调查-12(SF-12)和膝关节协会评分。

结果

共进行了469例TKA,患者平均年龄为68岁。患者前瞻性随访平均16年(范围14.8 - 19.5年)。以任何原因翻修为终点的15年Kaplan-Meier生存分析结果为96.4%(95.5% - 97.3%)。从术前到最近一次随访,西安大略和麦克马斯特大学关节炎指数以及膝关节协会评分均有显著改善(P < .001)。患者SF-12的身体健康综合评分从术前到最近一次随访有显著改善(P < .001),但SF-12的心理健康综合评分无变化。

结论

GENESIS II TKA系统独特的设计特点在其临床使用期间一直保持不变,这在当代TKA系统中较为罕见,因为当代TKA系统常在长期结果发表前就进行更改。GENESIS II在平均15年时继续展现出出色的长期生存率以及健康相关结局的改善,代表了我们机构TKA系统的标准。

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