Breugem Stefan J M, Linnartz Jeroen, Sierevelt Inger, Bruijn Jon D, Driessen Marcel J M
Orthopedium, Orthopedic Clinic, Delft 2616 LS, The Netherlands.
Slotervaart Hospital, Amsterdam 1066 EC, The Netherlands.
World J Orthop. 2017 Dec 18;8(12):922-928. doi: 10.5312/wjo.v8.i12.922.
To evaluate the influence of the titanium nitride (TiN) coating on the results of a total knee arthroplasty (TKA).
A total of 910 patients (338 men; 572 woman), with a mean age of 65 (range 36-94) undergoing 1031 primary TKAs were assessed. Clinical evaluation and patient-reported outcomes were gathered one year after surgery. The questionnaires included the Knee injury and Osteoarthritis Outcome Score (KOOS)-Dutch version, Visual Analogue Scale (VAS) pain scores in rest and during active knee movement, VAS-satisfaction scores, and EQ-5D-3L health scores. This was aimed to assess the overall knee function and patient satisfaction, and to enable us to make a gross comparison to other TKAs.
At a mean follow-up of 46 mo (range 1-92) the overall implant survival was 97.7% and 95.1% for any operative reason related to the implant. Twenty-three knees (2.2%) required revision surgery. Arthrofibrosis was the most common indication for a re-operation. The clinical evaluation and patient-reported outcomes revealed good to excellent patient satisfaction and function of the arthroplasty. The median postoperative VAS-pain scores on a scale of 0-100, at one year after surgery were 1 in rest and 2 during movement.
The TiN coated, mobile bearing TKA results are excellent and similar to those of other widely used TKA designs. Residual pain of the knee remains a concern and the TiN coating in combination with the mobile bearing does not seem to be the simple solution to this problem. Future research will have to show that the coating gives a better survival than the cobalt chrome version.
评估氮化钛(TiN)涂层对全膝关节置换术(TKA)结果的影响。
对910例患者(338例男性;572例女性)进行了评估,这些患者平均年龄为65岁(范围36 - 94岁),共接受了1031例初次TKA手术。术后一年收集临床评估和患者报告的结果。问卷包括膝关节损伤和骨关节炎结局评分(KOOS)荷兰版、静息及膝关节主动活动时的视觉模拟量表(VAS)疼痛评分、VAS满意度评分以及EQ - 5D - 3L健康评分。目的是评估膝关节整体功能和患者满意度,并使我们能够与其他TKA手术进行大致比较。
平均随访46个月(范围1 - 92个月),因与植入物相关的任何手术原因,植入物的总体生存率为97.7%,因植入物相关的任何手术原因导致的生存率为95.1%。23个膝关节(2.2%)需要翻修手术。关节纤维化是再次手术最常见的指征。临床评估和患者报告的结果显示患者对关节置换术的满意度和功能良好至优秀。术后一年,VAS疼痛评分中位数(0 - 100分制)在静息时为1分,活动时为2分。
TiN涂层的活动轴承TKA手术结果优异,与其他广泛使用的TKA设计相似。膝关节的残留疼痛仍然是一个问题,TiN涂层与活动轴承相结合似乎不是解决这个问题的简单方法。未来的研究必须表明该涂层比钴铬合金版本具有更好的生存率。