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初次全膝关节置换中,非骨水泥限制性髁假体与后稳定假体在失败率或临床结果方面无差异。

No difference in failure rates or clinical outcomes between non-stemmed constrained condylar prostheses and posterior-stabilized prostheses for primary total knee arthroplasty.

机构信息

Department of Orthopedic Surgery, Division of Adult Reconstruction, New York University Langone Orthopedic Hospital, 301 East 17th Street, Room 1402, New York, NY, 10003, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Sep;28(9):2942-2947. doi: 10.1007/s00167-019-05684-z. Epub 2019 Aug 27.

Abstract

PURPOSE

There has been an increase in the use of unlinked constrained condylar knee (CCK) prostheses in primary total knee arthroplasty (TKA) for cases with significant deformities that cannot be adequately balanced in flexion and extension. However, the literature on its outcomes is limited. The goal of this study is to evaluate whether there are any clinic or radiographic outcome differences for a primary, non-stemmed, unlinked constrained TKA as compared to a control group of posterior-stabilized (PS) TKA using the same implant design.

METHODS

Clinical and radiographic outcome measures for 404 cemented, non-stemmed, primary TKAs performed by two surgeons at the same institution were retrospectively reviewed. All patients underwent primary, non-stemmed components; 241 used CCK inserts and 163 used PS inserts. Preoperative deformity, knee society scores (KSS), range-of-motion (ROM), radiographic data and revision rates were compared between the CCK and PS groups.

RESULTS

Both groups had comparable demographics and preoperative ROM and KSS. At similar mean follow-up times (6.1 ± 1.0 years for the CCK group and 6.3 ± 1.2 years for the PS group), no significant difference was found in ROM, KSS or radiographic outcomes. Revision rates were higher for the CCK group (2%) as compared to the HF-PS (0.6%) group (n.s).

CONCLUSIONS

The particular design of cemented, primary, non-stemmed, unlinked CCK-TKA examined in this study provided similar clinical and radiographic outcomes to that of PS-TKA at midterm follow-up.

LEVEL OF EVIDENCE

III.

摘要

目的

在存在严重畸形且无法在屈伸过程中充分平衡的初次全膝关节置换术(TKA)中,使用非连接限制性髁膝关节假体(CCK)的情况有所增加。然而,关于其结果的文献有限。本研究的目的是评估与使用相同植入物设计的后稳定(PS)TKA 相比,非骨水泥、非骨水泥、非连接限制 TKA 的临床和影像学结果是否存在差异。

方法

回顾性分析了在同一机构由两位外科医生进行的 404 例骨水泥固定、非骨水泥、初次 TKA 的临床和影像学结果。所有患者均接受了初次、非骨水泥、非骨水泥组件;241 例使用 CCK 插入物,163 例使用 PS 插入物。比较 CCK 和 PS 组的术前畸形、膝关节协会评分(KSS)、活动范围(ROM)、影像学数据和翻修率。

结果

两组患者的人口统计学和术前 ROM 和 KSS 相似。在相似的平均随访时间(CCK 组为 6.1±1.0 年,PS 组为 6.3±1.2 年),ROM、KSS 或影像学结果无显著差异。CCK 组的翻修率较高(2%),而 HF-PS 组(0.6%)较低(n.s)。

结论

在这项研究中,检查的特定设计的骨水泥固定、非骨水泥、非骨水泥、非连接限制 CCK-TKA 在中期随访中提供了与 PS-TKA 相似的临床和影像学结果。

证据水平

III 级。

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