Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany.
Articon Christenorto AG, Schänzlistrasse 39, 3013, Bern, Switzerland.
Arch Orthop Trauma Surg. 2021 Feb;141(2):305-312. doi: 10.1007/s00402-020-03618-w. Epub 2020 Oct 26.
Determining the point at which a valgus deformity requires a more invasive therapy-in this case PS TKA-is surgically challenging. Retaining the posterior cruciate ligament has both advantages and disadvantages. The aim was to evaluate the failure rate and clinical outcomes.
248 patients with valgus gonarthrosis underwent surgical treatment: 167 CR TKA cases and 81 PS TKA cases. The KOOS and the OKS were recorded, and 201 patients (133 CR, 68 PS) were recruited into the retrospective study. The influence of BMI and degree of preoperative valgus deformity on the clinical outcome was determined. The revision rate was documented and analysed.
Of 201 patients, 10 required revision surgery owing to instability (10/133 CR, 0/68 PS). Based on the KOOS and the OKS, no significant difference between CR TKA and PS TKA was found. BMI and degree of valgus deformity had no effect on the clinical outcome.
No difference in the clinical outcome between the CR and PS TKA patients was found. In the CR group, significantly more patients showed 'excellent' OKS than in the PS group. However, 8.0% of the patients in the CR group and none in the PS group underwent surgery due to instability. A higher rate of dissatisfied patients in the CR group is likely. In our clinic, we no longer perform CR TKA for valgus cases.
确定需要更具侵入性治疗（在这种情况下为 PS TKA）的外翻畸形的临界点具有挑战性。保留后交叉韧带有其优点和缺点。目的是评估失败率和临床结果。
248 例外翻性膝关节骨关节炎患者接受了手术治疗：167 例 CR TKA 病例和 81 例 PS TKA 病例。记录 KOOS 和 OKS，并对 201 例患者（133 例 CR，68 例 PS）进行回顾性研究。确定 BMI 和术前外翻畸形程度对临床结果的影响。记录并分析翻修率。
在 201 例患者中，有 10 例因不稳定而需要进行翻修手术（10/133 CR，0/68 PS）。基于 KOOS 和 OKS，CR TKA 和 PS TKA 之间无明显差异。BMI 和外翻畸形程度对临床结果无影响。
CR 和 PS TKA 患者的临床结果无差异。在 CR 组中，有明显更多的患者 OKS 为“优秀”，而 PS 组则没有。然而，在 CR 组中，有 8.0%的患者因不稳定而接受手术，而 PS 组则没有。CR 组中不满意的患者比例可能更高。在我们的诊所，我们不再为外翻病例进行 CR TKA。
