Zicaro Juan Pablo, Yacuzzi Carlos, Astoul Bonorino Juan, Carbo Lisandro, Costa-Paz Matias
Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Knee. 2017 Dec;24(6):1485-1491. doi: 10.1016/j.knee.2017.09.003. Epub 2017 Oct 8.
This study evaluated the clinical and radiographic outcomes of a series of patients treated with an anatomic inlay resurfacing implant, with a minimum two-year follow-up.
Fifteen patients underwent patellofemoral-resurfacing procedures using a HemiCAP Wave Patellofemoral Inlay Resurfacing implant from 2010 to 2013. Clinical outcomes included: Visual Analog Scale (VAS), Lysholm score, Knee Society Score (KSS), and evaluation of Kujala, and Hospital for Special Surgery Patellofemoral score (HSS-PF). The postoperative complications were analyzed.
Nineteen knees were evaluated; the average follow-up was 35.2months. Fourteen were women, with an average age of 54years. The pre-operative/postoperative clinical results presented a significant improvement: VAS 8/2.5, Lysholm 31.9/85.8, KSS 39.8/82.5, Kujala 32.1/79.3 and Hospital for Special Surgery Patellofemoral score (HSS-PF) 15.9/90.6. A total of 87% of patients were either satisfied or very satisfied with the overall outcome. There were no radiographic signs of loosening. Seven postoperative complications were recorded: two presented ongoing knee pain, one postoperative stiffness, one patellar bounce due to maltracking, two ilio-tibial band syndrome, and one tibial anterior tuberosity osteotomy nonunion. Two patients underwent a total knee arthroplasty conversion and were considered a failure. None of these complications were implant related.
Patellofemoral inlay resurfacing for isolated patellofemoral arthritis was an effective and safe procedure with high levels of patient satisfaction. No mechanical implant failure was seen at a minimum two-year follow-up. This implant design appeared to be an alternative to the traditional patellofemoral prostheses. Concomitant osteochondral lesions, patellofemoral dysplasia or patellar maltracking might be poor prognostic factors for this type of implant.
本研究评估了一系列接受解剖镶嵌式表面置换植入物治疗且随访至少两年的患者的临床和影像学结果。
2010年至2013年期间，15例患者接受了使用HemiCAP Wave髌股镶嵌式表面置换植入物的髌股表面置换手术。临床结果包括：视觉模拟评分（VAS）、Lysholm评分、膝关节协会评分（KSS）、Kujala评估以及特种外科医院髌股评分（HSS-PF）。对术后并发症进行了分析。
评估了19个膝关节；平均随访时间为35.2个月。14例为女性，平均年龄54岁。术前/术后临床结果有显著改善：VAS为8/2.5、Lysholm为31.9/85.8、KSS为39.8/82.5、Kujala为32.1/79.3以及特种外科医院髌股评分（HSS-PF）为15.9/90.6。共有87%的患者对总体结果感到满意或非常满意。没有影像学上的松动迹象。记录了7例术后并发症：2例持续存在膝关节疼痛，1例术后僵硬，1例因轨迹不良导致髌骨弹跳，2例髂胫束综合征，1例胫骨前结节截骨不愈合。2例患者接受了全膝关节置换翻修，被视为手术失败。这些并发症均与植入物无关。
对于孤立性髌股关节炎，髌股镶嵌式表面置换是一种有效且安全的手术，患者满意度高。在至少两年的随访中未观察到机械性植入物失败。这种植入物设计似乎是传统髌股假体的一种替代方案。合并的骨软骨损伤、髌股发育不良或髌骨轨迹不良可能是这类植入物的不良预后因素。
