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亚洲患者单髁置换术的长期临床疗效:一项平均 10 年随访研究。

Long-term clinical outcomes of medial pivot total knee arthroplasty for Asian patients: A mean 10-year follow-up study.

机构信息

Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno, Osaka, Japan; Department of Orthopedic Surgery, Tanabe Central Hospital, 147 Minamishinmachi, Tanabe City, Wakayama 646-0042, Japan.

Department of Orthopedic Surgery, Tanabe Central Hospital, 147 Minamishinmachi, Tanabe City, Wakayama 646-0042, Japan.

出版信息

Knee. 2020 Dec;27(6):1778-1786. doi: 10.1016/j.knee.2020.09.009. Epub 2020 Nov 13.

Abstract

BACKGROUND

Many Asian populations have a unique floor-based lifestyle that might cause mechanical stress of the knees. It is important to clarify the longevity of a medial pivot total knee arthroplasty, as its prosthetic design could cause mechanical stress onto the insert. The purpose of this study was to clarify the clinical results of medial pivot total knee arthroplasty for Asian patients in a 10-year follow-up study.

METHODS

Consecutive, primary total knee arthroplasties (n = 257) were analyzed in the study using the medial pivot knee system. The clinical outcomes were assessed preoperatively and at the final follow-up. The patient-reported Forgotten Joint Score-12 and radiological outcomes were measured at the final follow-up. The survival rate was assessed with reoperation or revision as the end-point.

RESULTS

The mean follow-up period was 10.1 ± 1.7 years. The lost to follow-up was 4.5%. All clinical outcomes improved significantly after surgery (p < 0.001). The mean postoperative knee flexion was 118° ± 11° and the mean Forgotten Joint Score-12 was 59.7 ± 27 points. The radiolucent line was observed in 29 patients (11.3%), however there was no aseptic loosening noted. The survival rates with reoperation or revision were 96.3% or 98.4% at 10 years after the operation.

CONCLUSIONS

Medial pivot total knee arthroplasty used for Asian patients showed good longevity and patient-reported outcome measurement in a mean 10-year follow-up study. Medial pivot total knee arthroplasty has long-term stability among patients who have a floor-based lifestyle.

LEVEL OF EVIDENCE

III.

摘要

背景

许多亚洲人群有一种独特的基于地面的生活方式,可能会导致膝关节的机械性压力。澄清内侧枢轴全膝关节置换术的使用寿命很重要,因为其假体设计可能会对植入物造成机械性压力。本研究的目的是在 10 年的随访研究中阐明内侧枢轴全膝关节置换术对亚洲患者的临床效果。

方法

本研究连续分析了 257 例使用内侧枢轴膝关节系统的原发性全膝关节置换术患者。术前和最终随访时评估临床结果。在最终随访时测量患者报告的遗忘关节评分-12 和影像学结果。以再次手术或翻修为终点评估生存率。

结果

平均随访时间为 10.1±1.7 年。失访率为 4.5%。所有临床结果在手术后均显著改善(p<0.001)。术后平均膝关节屈曲度为 118°±11°,遗忘关节评分-12 平均为 59.7±27 分。29 例(11.3%)患者出现透亮线,但无无菌性松动。术后 10 年再次手术或翻修的生存率分别为 96.3%和 98.4%。

结论

在平均 10 年的随访研究中,内侧枢轴全膝关节置换术用于亚洲患者显示出良好的长期效果和患者报告的结果测量。对于具有基于地面的生活方式的患者,内侧枢轴全膝关节置换术具有长期稳定性。

证据水平

III 级。

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