Faculty of Medicine, Zagazig University, Zagazig city, 4451, Ash Sharqia Governorate, Egypt.
Eur J Orthop Surg Traumatol. 2021 May;31(4):695-703. doi: 10.1007/s00590-020-02816-x. Epub 2020 Oct 30.
There is no consensus in the literature regarding the patients with obesity who do well with TKA, or this group is at risk of a variety of complications. Implant choices between the two types of implants which either long or standard stem can improve the likelihood that a patient with obesity will achieve high scores for function and quality of life after TKA.
This prospective clinical study included 200 patients who were categorized into two groups: group (1) traditional (standard) unstemmed cemented tibial tray (n = 100 patients) and group (2) stemmed cemented tibial tray with the cementless press-fit stem (n = 100 patients).
The average follow-up was (7.6 ± 1 years) (range from 6.5 up to 10 years). The average age of the stemmed group was 55.69 ± 8.45 and for the unstemmed group was 57.3 ± 7.8. The average BMI for the stemmed patients was 38.84 ± 3.89, while for the standard (unstemmed) group was 40.0 ± 3.95. Functional results showed significant improvement in both groups but more in the stemmed group (LS) as the difference and change between pre and post were more significant at long stem (P > 0.001).
Based on our results, there were significant improvements in both groups either stemmed or unstemmed TKA but more in the stemmed group which had higher functional outcomes compared to the unstemmed group.
IV.
文献中对于肥胖患者接受 TKA 效果较好的患者或该人群存在多种并发症风险的患者没有共识。在这两种类型的植入物中选择植入物，无论是长柄还是标准柄，都可以提高肥胖患者在 TKA 后获得高功能和生活质量评分的可能性。
本前瞻性临床研究纳入了 200 例患者，将其分为两组：组 1（传统的标准未柄化水泥固定胫骨托组，n = 100 例）和组 2（带水泥非压配柄的柄化水泥固定胫骨托组，n = 100 例）。
平均随访时间为（7.6 ± 1 年）（范围从 6.5 年到 10 年）。柄化组的平均年龄为 55.69 ± 8.45 岁，非柄化组为 57.3 ± 7.8 岁。柄化患者的平均 BMI 为 38.84 ± 3.89，而标准（非柄化）组为 40.0 ± 3.95。功能结果显示两组均有显著改善，但柄化组改善更明显（LS），因为长柄（P > 0.001）的术前和术后差异和变化更显著。
根据我们的结果，无论是否使用柄，TKA 组的两组患者都有显著的改善，但柄化组的功能结果更好，与非柄化组相比，其功能结果更高。
IV。
