Aujla Randeep S, Esler Colin N
Department of Orthopaedic Surgery, Leicester Royal Infirmary, Leicester, United Kingdom.
J Arthroplasty. 2017 Aug;32(8):2598-2603.e1. doi: 10.1016/j.arth.2017.02.069. Epub 2017 Mar 3.
The proportion of younger patients undergoing total knee arthroplasty (TKA) is increasing and predictions state that the <55 age group will be the fastest growing group by 2030. We aim to collate data across studies to assess functional outcomes following TKA in patients <55 years of age using a systematic review.
The search identified 980 studies for title and abstract review. Forty-three full texts were then assessed. Thirteen studies underwent quality assessment and data extraction. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed throughout. Outcomes extracted included pre-operative and post-operative functional scores, range of motion, and patient satisfaction. Clinical complications and survival were also recorded.
Across 13 studies we were able to demonstrate 54-point improvement in clinical Knee Society Score and a 46-point improvement on functional Knee Society Score. A 2.9° improvement in range of motion was found at final follow-up. Satisfaction rate was 85.5%. Cumulative percentage all-cause revision rate was 5.4% across 1283 TKAs at a mean 10.8 years of follow-up. Ten-year survival, for aseptic loosening alone, was 98.2%.
TKA is an excellent treatment option for the young osteoarthritic knee with a >50% improvement in functional knee scores. Satisfaction is high and the revision rate remains 0.5% per year.
接受全膝关节置换术（TKA）的年轻患者比例正在增加，据预测，到2030年，年龄小于55岁的人群将成为增长最快的群体。我们旨在通过系统评价整理各项研究的数据，以评估55岁以下患者TKA后的功能结局。
检索到980项研究用于标题和摘要审查。随后评估了43篇全文。13项研究进行了质量评估和数据提取。整个过程遵循系统评价和Meta分析的首选报告项目指南。提取的结局包括术前和术后功能评分、活动范围和患者满意度。还记录了临床并发症和生存率。
在13项研究中，我们能够证明临床膝关节协会评分提高了54分，功能膝关节协会评分提高了46分。末次随访时活动范围改善了2.9°。满意度为85.5%。在平均10.8年的随访中，1283例TKA的全因翻修累积百分比为5.4%。仅无菌性松动的10年生存率为98.2%。
TKA是年轻骨关节炎膝关节的一种优秀治疗选择，功能膝关节评分提高超过50%。满意度高，翻修率每年仍保持在0.5%。
