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新型解剖型膝关节系统的早期结果令人鼓舞。

Promising early outcomes of a novel anatomic knee system.

机构信息

Harris Orthopaedic Laboratory, Massachusetts General Hospital, 55 Fruit St. GRJ 1231, Boston, MA, 02114, USA.

Department of Orthopaedic Surgery, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 Apr;27(4):1067-1074. doi: 10.1007/s00167-018-5248-0. Epub 2018 Oct 25.

Abstract

PURPOSE

The primary aim of this study was to report the early clinical and radiographic outcomes of patients who have been treated with total knee arthroplasty (TKA) using the Persona knee system. The secondary aim was to compare patient-reported outcomes (PROs) of the Persona knee system to those of the NexGen implant.

METHODS

A registry-based study of a consecutive series of 112 patients (129 knees) treated with the Persona knee system from a single center was conducted. Preoperative, 1-year, and 2-year radiographs and PROs were analyzed. Postoperative radiographs were assessed for radiolucency and component positioning. Patients were monitored for postoperative complications and revision. Two-year PROs were compared to a 1:1 propensity score-matched cohort of patients treated with the NexGen knee system.

RESULTS

Ninety-five percent of knees were within literature-defined safe ranges of the anatomical tibiofemoral axis, tibial varus/valgus angle, femoral flexion/extension angle, and tibial slope. Radiolucency was observed in 0.9% and 1.3% of knees at one and 2 years, respectively. Two-year PRO values demonstrated clinically meaningful improvements from the preoperative values. The cumulative 2-year percent revision was 3.0% (95% confidence interval 1.9-3.8%); there were no revisions due to implant mechanical failure. Patients treated with the Persona knee system had higher KOOS symptom (p = 0.037) and KOOS QOL (p < 0.001) scores compared to patients with the NexGen knee system.

CONCLUSIONS

This knee design demonstrates excellent clinical outcomes, similar or better than the NexGen knee system, at early follow-up.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究的主要目的是报告使用 Persona 膝关节系统治疗全膝关节置换术(TKA)患者的早期临床和影像学结果。次要目的是比较 Persona 膝关节系统与 NexGen 植入物的患者报告结局(PRO)。

方法

对单中心连续 112 例(129 膝)使用 Persona 膝关节系统治疗的患者进行基于注册的研究。分析了术前、1 年和 2 年的 X 线片和 PRO。术后 X 线片评估了透光率和组件位置。监测患者术后并发症和翻修情况。将 2 年 PRO 与接受 NexGen 膝关节系统治疗的 1:1 倾向评分匹配队列的 PRO 进行比较。

结果

95%的膝关节处于文献定义的解剖胫股轴、胫骨内翻/外翻角、股骨屈曲/伸展角和胫骨倾斜角的安全范围内。分别在 1 年和 2 年时,有 0.9%和 1.3%的膝关节出现透光现象。2 年 PRO 值较术前有临床意义的改善。2 年累计翻修率为 3.0%(95%置信区间 1.9-3.8%);无因植入物机械故障导致的翻修。与接受 NexGen 膝关节系统治疗的患者相比,接受 Persona 膝关节系统治疗的患者 KOOS 症状(p=0.037)和 KOOS QOL(p<0.001)评分更高。

结论

在早期随访中,这种膝关节设计显示出出色的临床结果,与 NexGen 膝关节系统相似或更好。

证据水平

III 级。

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