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使用全稳定型膝关节系统进行翻修全膝关节置换术的生存情况和功能结果:至少5年随访

Survival and functional outcome of revision total knee arthroplasty with a total stabilizer knee system: minimum 5 years of follow-up.

作者信息

Stevens Jarrad M, Clement Nicholas D, MacDonald Deborah, Hamilton David F, Burnett Richard

机构信息

Department of Orthopaedics, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.

Knox Orthopaedic Group, Knox Private Hospital, Melbourne, Australia.

出版信息

Eur J Orthop Surg Traumatol. 2019 Oct;29(7):1511-1517. doi: 10.1007/s00590-019-02449-9. Epub 2019 May 25.

Abstract

INTRODUCTION

Revision knee arthroplasty surgery can range from patella resurfacing or polyethylene exchange, to staged revision and revision to a more constrained implant. Subsequently, the ability to elicit outcomes becomes difficult to obtain and hence information on functional outcome and survivorship for all modes of failure with a single revision system is valuable.

METHODS

We retrospectively assessed 100 consecutive revision knee replacements that were converted from a primary knee replacement to a Triathlon total stabilizer (TS) knee system (Stryker Orthopaedics, Mahwah, NJ). Inclusion criteria included failure of a primary knee replacement of any cause converted to a Stryker TS knee system. Midterm outcome of at least 5 years was required. Implants survivorship, Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12), Short Form (SF-) 12, reported patient satisfaction and radiographic analysis were recorded.

RESULTS

The all-cause survival rate at 5 years was 89.0% [95% confidence interval (CI) 87.3 to 90.7]. The all-cause survival rate was generally static after the first 4 years. The mean OKS was 27 (SD 11.9, range 0 to 46), FJS was 32.3 (SD 30.4, range 0 to 100), SF-12 physical component summary was 40.6 (SD 17.6, range 23.9 to 67.1), and mental component summary was 48.3 (SD 15.5, range 23.9 to 69.1). Reported patient satisfaction in patients who were not re-revised was 82%.

CONCLUSION

The midterm survivorship of cemented Stryker Triathlon TS knee revision for all-cause mode of failure is good to excellent; however, future follow-up is required to ensure this survivorship is observed into the long term. Despite limited functional outcome, overall patient satisfaction rates are high.

摘要

引言

膝关节翻修手术范围从髌骨表面置换或聚乙烯垫片更换,到分期翻修以及更换为更具限制性的假体。随后,要得出结果变得困难,因此关于单一翻修系统所有失败模式的功能结果和假体生存率的信息很有价值。

方法

我们回顾性评估了100例连续的膝关节翻修置换病例,这些病例均从初次膝关节置换转换为Triathlon全稳定型(TS)膝关节系统(史赛克骨科公司,新泽西州马哈瓦)。纳入标准包括因任何原因导致的初次膝关节置换失败并转换为史赛克TS膝关节系统。需要至少5年的中期结果。记录假体生存率、牛津膝关节评分(OKS)、遗忘关节评分(FJS-12)、简明健康状况调查量表(SF-12)、报告的患者满意度以及影像学分析。

结果

5年时的全因生存率为89.0%[95%置信区间(CI)87.3至90.7]。前4年后全因生存率总体保持稳定。平均OKS为27(标准差11.9,范围0至46),FJS为32.3(标准差30.4,范围0至100),SF-12身体成分总结评分为40.6(标准差17.6,范围23.9至67.1),精神成分总结评分为48.3(标准差15.5,范围23.9至69.1)。未再次翻修患者报告的满意度为82%。

结论

对于全因失败模式,骨水泥固定的史赛克Triathlon TS膝关节翻修的中期生存率良好至优秀;然而,需要未来的随访以确保长期观察到这种生存率。尽管功能结果有限,但总体患者满意度较高。

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