Singleton Neal, Nicholas Bryden, Gormack Nick, Stokes Andrew
Orthopaedic Department, Tauranga Hospital, Tauranga, New Zealand.
J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019848154. doi: 10.1177/2309499019848154.
Both cruciate retaining (CR) and posterior stabilized (PS) implants are commonly used for primary total knee arthroplasty. There is evidence to support improved range of motion in PS knee replacements, but there is no evidence showing functional superiority. The aim of this study was to compare functional outcomes between CR and PS knee replacements.
Prospectively collected regional joint registry data were used to compare preoperative and postoperative one, 5- and 10-year Oxford and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in 1287 primary total knee replacements. Differences in functional scores between CR and PS knees were calculated.
The PS group had better functional scores than the CR group at baseline (mean Oxford score 15.59 vs. 14.52 ( p = 0.026) and mean WOMAC score 59.51 vs. 62.35 ( p = 0.012)), at 1 year postoperatively (mean Oxford score 37.94 vs. 36.63 ( p = 0.015) and mean WOMAC score 16.20 vs. 19.73 ( p = 0.001)) with a similar trend at 5 years postoperatively (mean Oxford score 39.66 vs. 38.50 ( p = 0.054) and mean WOMAC score 16.89 vs. 18.83 ( p = 0.131)). There was no difference in the overall functional improvement between the PS and CR groups at 1, 5, or 10 years. WOMAC subcomponent scores showed greater improvement in stiffness; 3.76 versus 3.36 ( p = 0.012) in PS knees at 1 year postoperatively. No significant differences were observed at 5 or 10 years.
PS knee replacements showed greater improvement in stiffness at 1 year postoperatively. There was no difference observed at 5 or 10 years postoperatively. PS knees had better functional outcomes at 1 year with a similar trend at 5 years postoperatively.
III.
保留交叉韧带（CR）和后稳定型（PS）假体在初次全膝关节置换术中均常用。有证据支持PS膝关节置换术后活动范围改善，但无证据表明其功能更优越。本研究旨在比较CR和PS膝关节置换术后的功能结局。
前瞻性收集的区域关节登记数据用于比较1287例初次全膝关节置换术前及术后1年、5年和10年的牛津大学和西安大略及麦克马斯特大学骨关节炎指数（WOMAC）评分。计算CR和PS膝关节功能评分的差异。
PS组在基线时（平均牛津评分15.59对14.52（p = 0.026），平均WOMAC评分59.51对62.35（p = 0.012））、术后1年（平均牛津评分37.94对36.63（p = 0.015），平均WOMAC评分16.20对19.73（p = 0.001））功能评分优于CR组，术后5年有类似趋势（平均牛津评分39.66对38.50（p = 0.054），平均WOMAC评分16.89对18.83（p = 0.131））。PS组和CR组在1年、5年或10年的总体功能改善无差异。WOMAC子成分评分显示在僵硬方面改善更大；术后1年PS膝关节为3.76对3.36（p = 0.012）。在5年或10年未观察到显著差异。
PS膝关节置换术后1年在僵硬方面改善更大。术后5年或10年未观察到差异。PS膝关节在1年时功能结局更好，术后5年有类似趋势。
III级
