Department of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2130AT, Hoofddorp, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2020 Sep;28(9):2970-2979. doi: 10.1007/s00167-019-05725-7. Epub 2019 Sep 24.
Chondrocalcinosis is the radiographic appearance of calcium crystals in cartilage and other soft tissue. It is suggested that preoperative chondrocalcinosis predicts a worse outcome after total knee arthroplasty and it is unclear if chondrocalcinosis leads to more postoperative complications. This study aimed to compare function, pain, postoperative complications, postoperative signs of acute arthritis and revision rates between patients with and without chondrocalcinosis undergoing total knee arthroplasty for osteoarthritis.
In this retrospective cohort study performed in 2017, 408 knees in 392 patients (16 bilateral total knee arthroplasties) were included. None of the patients received additional synovectomy. PROMs were evaluated after 1 year (n = 294) and 5 years (n = 308). The follow-up for clinical data was 5 years (n = 408). The range of final follow-up was 57-84 months. All preoperative radiographs were scored for chondrocalcinosis and Oxford Knee Score, Knee Society Score and Algofunctional Index were used to assess outcome. All clinical records were screened for postoperative complications (excessive wound discharge, infection, loosening, PAO, stiffness), arthritis after surgery and reoperation or revision for any reason.
Sixty-three knees (15.4%) showed signs of chondrocalcinosis. Male gender, higher age and lower BMI were risk factors for chondrocalcinosis. No difference was found in Oxford Knee Score, Knee Society Score and Algofunctional Index, nor in postoperative complications, postoperative signs of acute arthritis and revision rate.
Patients with and without chondrocalcinosis have the same outcome after total knee arthroplasty related to pain, functionality, complications, arthritis and revision after surgery for end-stage osteoarthritis. Chondrocalcinosis is not a contraindication for total knee arthroplasty and additional synovectomy is unnecessary.
III.
软骨钙质沉着症是指软骨和其他软组织中钙晶体的放射影像学表现。有研究表明，术前软骨钙质沉着症预示着全膝关节置换术后的结果更差，并且尚不清楚软骨钙质沉着症是否会导致更多的术后并发症。本研究旨在比较患有和不患有软骨钙质沉着症的骨关节炎患者行全膝关节置换术后的功能、疼痛、术后并发症、术后急性关节炎表现和翻修率。
在 2017 年进行的这项回顾性队列研究中，纳入了 392 名患者（16 例双侧全膝关节置换术）的 408 膝。所有患者均未接受额外的滑膜切除术。在术后 1 年（n=294）和 5 年（n=308）时评估了 PROMs。临床数据的随访时间为 5 年（n=408）。最终随访时间范围为 57-84 个月。所有术前的 X 线片均进行软骨钙质沉着症评分，并采用牛津膝关节评分（Oxford Knee Score，OKS）、膝关节协会评分（Knee Society Score，KSS）和 Algofunctional 指数（Algofunctional Index，AIF）评估结局。所有临床记录均筛查了术后并发症（过度伤口渗出、感染、松动、PAO、僵硬）、术后关节炎以及任何原因的再次手术或翻修。
63 膝（15.4%）存在软骨钙质沉着症的迹象。男性、较高的年龄和较低的 BMI 是软骨钙质沉着症的危险因素。在 OKS、KSS 和 AIF 评分、术后并发症、术后急性关节炎表现和翻修率方面，两组之间无差异。
在与疼痛、功能、并发症、关节炎和术后翻修相关的终末期骨关节炎行全膝关节置换术后，有和没有软骨钙质沉着症的患者结局相同。软骨钙质沉着症不是全膝关节置换术的禁忌证，也不需要额外的滑膜切除术。
III 级。
