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KineSpring系统失效后进行单髁膝关节置换术能否成为一种可行的选择？一例病例报告。

Can UKA after KineSpring system failure be a viable option? A case report.

作者信息

Niccoli Giuseppe, Di Benedetto Paolo, Salviato Daniele, Beltrame Alessandro, Gisonni Renato, Cainero Vanni, Causero Araldo

机构信息

.

出版信息

Acta Biomed. 2019 Jan 10;90(1-S):192-197. doi: 10.23750/abm.v90i1-S.8075.

DOI:10.23750/abm.v90i1-S.8075
PMID:30715024
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6503415/
Abstract

BACKGROUND AND AIM OF THE WORK

The KineSpring System is an alternative treatment offered in selected symptomatic patients suffering from mild to moderate medial knee osteoarthritis (OA). This device reduces medial compartment loads in the OA knee without compromising the integrity of the lateral or patellofemoral knee compartments, maintaining the normal knee anatomy. Currently, papers about KineSpring System installation show promising results. The current authors describe a case of unicompartmental knee arthroplasty (UKA) employed to treat medial knee OA after Kinespring system failure.

METHODS

A 64-year old male patient presented to our hospital after failure of a Kinespring system implantation into his left knee at an external hospital, where the outcomes obtained were not satisfactory. The surgical options discussed with the patient were the TKA or medial UKA. A medial UKA was preferred by the patient.

RESULTS

One year from UKA, the patient complained of frequent joint effusions and weight bearing pain despite a good ROM without radiographic signs of implant loosening. Therefore, after two years we replaced UKA with total knee arthroplasty (TKA).

CONCLUSIONS

Further experience is needed to provide reliable clinical data about the results of the UKA after KineSpring System discharge.

摘要

工作背景与目的

KineSpring系统是为患有轻至中度膝关节内侧骨关节炎（OA）的特定有症状患者提供的一种替代治疗方法。该装置可减轻OA膝关节内侧间室的负荷，同时不损害膝关节外侧或髌股间室的完整性，维持膝关节正常解剖结构。目前，有关KineSpring系统植入的文献显示出有前景的结果。本文作者描述了1例在KineSpring系统失效后采用单髁膝关节置换术（UKA）治疗膝关节内侧OA的病例。

方法

一名64岁男性患者在外部医院左膝KineSpring系统植入失败后来到我院，在外部医院获得的治疗结果并不理想。与患者讨论的手术选择是全膝关节置换术（TKA）或内侧UKA。患者更倾向于内侧UKA。

结果

UKA术后1年，尽管患者关节活动度良好且无植入物松动的影像学迹象，但仍主诉频繁出现关节积液和负重疼痛。因此，2年后我们将UKA翻修为全膝关节置换术（TKA）。

结论

需要更多经验来提供关于KineSpring系统取出后UKA结果的可靠临床数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/d931eb6bb373/ACTA-90-192-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/8850efc646b9/ACTA-90-192-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/89439641058d/ACTA-90-192-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/3993b8af05a2/ACTA-90-192-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/026631777818/ACTA-90-192-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/8ef9c7a5fcba/ACTA-90-192-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/1955db7755cf/ACTA-90-192-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/d931eb6bb373/ACTA-90-192-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/8850efc646b9/ACTA-90-192-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/89439641058d/ACTA-90-192-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/3993b8af05a2/ACTA-90-192-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/026631777818/ACTA-90-192-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/8ef9c7a5fcba/ACTA-90-192-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/1955db7755cf/ACTA-90-192-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a4/6503415/d931eb6bb373/ACTA-90-192-g007.jpg

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本文引用的文献

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EFORT Open Rev. 2018 Aug 1;3(8):442-448. doi: 10.1302/2058-5241.3.170060. eCollection 2018 Aug.
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Use of the KineSpring system in the treatment of medial knee osteoarthritis: preliminary results.KineSpring系统在治疗膝关节内侧骨关节炎中的应用：初步结果。
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Safety and Feasibility of a KineSpring Knee System for the Treatment of Osteoarthritis: A Case Series.
用于治疗骨关节炎的KineSpring膝关节系统的安全性和可行性：病例系列研究
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Joint unloading implant modifies subchondral bone trabecular structure in medial knee osteoarthritis: 2-year outcomes of a pilot study using fractal signature analysis.关节卸载植入物改变了膝关节内侧骨关节炎的软骨下骨小梁结构：一项使用分形特征分析的前瞻性研究的2年结果
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Clin Orthop Relat Res. 2015 Jan;473(1):90-3. doi: 10.1007/s11999-014-3712-9.
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