Lee Merrill, Chen Jerry Yongqiang, Ying Hao, Nee Pang Hee, Tay Darren Keng Jin, Chin Pak Lin, Lu Chia Shi, Nung Lo Ngai, Jin Yeo Seng
1 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
2 Health Services Research Unit (HSRU), Division of Medicine, Singapore General Hospital, Singapore, Singapore.
J Orthop Surg (Hong Kong). 2018 May-Aug;26(3):2309499018792417. doi: 10.1177/2309499018792417.
The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome.
One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012. A propensity score matching algorithm was used to select 103 MR TKAs performed during the same period. Preoperative and postoperative variables such as standardized knee and quality of life scores were captured prospectively and then analyzed via both the Student's t-test and paired t-test to look for statistically significant differences between the SR and MR patient groups.
At 2 years postoperatively, there was no statistically significant difference between the SR and MR patient populations in knee extension, Oxford Knee Score, Knee Society Clinical Rating Scores, and the Physical Component Summary of the Short Form 36 Health Survey (SF-36). There was a statistically significant difference between the two patient groups in postoperative knee flexion in favor of the MR design ( p = 0.011).
While an SR femoral implant design has several theoretical biomechanical advantages, postoperative standardized KSCs and quality of life scores in this single-surgeon series do not show a clear advantage of one design over the other.
III.
本研究的主要目的是比较接受单半径（SR）或多半径（MR）全膝关节置换术（TKA）患者的生活质量和功能结局。次要目的是观察这些患者膝关节活动范围（ROM）和标准化膝关节评分（KSC）的变化。假设是两组患者在生活质量和功能结局方面无统计学显著差异。
2008年8月至2012年12月期间，由一名外科医生实施了103例SR TKA手术。采用倾向评分匹配算法选择同期进行的103例MR TKA手术。前瞻性收集术前和术后变量，如标准化膝关节和生活质量评分，然后通过学生t检验和配对t检验进行分析，以寻找SR组和MR组患者之间的统计学显著差异。
术后2年，SR组和MR组患者在膝关节伸展、牛津膝关节评分、膝关节协会临床评级评分以及简短健康调查问卷（SF - 36）的身体成分总结方面无统计学显著差异。两组患者在术后膝关节屈曲方面存在统计学显著差异，MR设计更具优势（p = 0.011）。
虽然SR股骨植入物设计具有若干理论生物力学优势，但在这个单外科医生系列中，术后标准化KSC和生活质量评分并未显示出一种设计相对于另一种设计有明显优势。
III级。
