Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2124-2129. doi: 10.1007/s00167-019-05407-4. Epub 2019 Feb 14.
Total knee arthroplasty (TKA) designs continuously evolve with the aim of improving patient outcomes. The purpose of the current study was to compare clinical and patient-reported outcome (PRO) results of a new TKA implant to its predecessor. The hypothesis of this study was that joint awareness and range of motion (ROM) of the newer design would be better than the classic design.
One hundred patients undergoing TKA using the newer design (Attune) were matched by age and gender to 200 patients with the classic design (LCS). All patients underwent computer-navigated (Vector Vision, Brain-Lab, Germany) primary TKA by the same surgeon using the same technique. Data (FJS-12, WOMAC and ROM) were collected preoperatively and at 12 months follow-up at our implant registry.
Compared to preoperative scores, FJS-12, WOMAC and ROM improved significantly at 12 months follow-up. In the Attune group, mean FJS-12 and WOMAC at follow-up were 67.6 (SD 27.8) and 14.8 (SD 14.9) respectively, compared to 70.8 (SD 33.8) and 15 (SD 17.9) in the LCS group. Mean postoperative ROM was similar in both groups (Attune 120°, range 90°-140°, SD 10.4 and LCS 120°, range 85°-140°, SD 10.3).
The newer TKA and the predecessor design achieved comparable joint awareness, WOMAC scores and ROM at 1-year follow-up. The benefits expected of the newer design could not be observed in early clinical and PROs. The clinical relevance of this study is that it questions the importance of implant design as the single most important factor for patient outcomes.
III.
全膝关节置换术（TKA）的设计不断发展，旨在改善患者的治疗效果。本研究的目的是比较新型 TKA 植入物与前代产品的临床和患者报告的结果（PRO）。本研究的假设是，新型设计的关节感知和活动范围（ROM）将优于经典设计。
100 例接受新型设计（Attune）TKA 的患者，按照年龄和性别与 200 例接受经典设计（LCS）TKA 的患者进行匹配。所有患者均由同一位外科医生采用相同的技术，通过计算机导航（德国 Brain-Lab 的 Vector Vision）进行初次 TKA。在我们的植入物登记处，在术前和 12 个月随访时收集数据（FJS-12、WOMAC 和 ROM）。
与术前评分相比，FJS-12、WOMAC 和 ROM 在 12 个月随访时均显著改善。在 Attune 组中，FJS-12 和 WOMAC 的平均随访分数分别为 67.6（SD 27.8）和 14.8（SD 14.9），而 LCS 组分别为 70.8（SD 33.8）和 15（SD 17.9）。两组术后 ROM 相似（Attune 120°，范围 90°-140°，SD 10.4；LCS 120°，范围 85°-140°，SD 10.3）。
新型 TKA 和前代设计在 1 年随访时，关节感知、WOMAC 评分和 ROM 相当。新型设计预期的优势在早期临床和 PRO 中无法观察到。本研究的临床意义在于，它质疑了植入物设计作为患者治疗效果的唯一最重要因素的重要性。
III。
