Hintze Jake von, Niemeläinen Mika, Sintonen Harri, Nieminen Jyrki, Eskelinen Antti
Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland.
Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland.
Knee. 2021 Jan;28:273-281. doi: 10.1016/j.knee.2020.12.016. Epub 2021 Jan 13.
The prognosis of complex primary total knee arthroplasty (TKA) with severe deformity and ligament deficiency is not clear. There is a paucity of evidence in the current literature on treatment outcomes of the rotating hinge knee implants in primary TKA. The aim of this study was to determine the mid-term clinical, radiographic, and health-related quality of life (HRQoL) outcomes in patients who had undergone complex primary TKA using single hinged knee replacement.
In total, 106 complex primary TKAs (101 patients) were performed using the single rotating hinged knee (RHK) implant design at our institution between January 2004 and December 2013. We conducted a retrospective analysis of prospectively collected outcome data of these patients, obtaining also information on all possible revision surgeries from the Finnish Arthroplasty Register, and conducted a prospective follow-up study of all living patients.
The 10-year Kaplan-Meier survival rate of the RHK knees was 91.6% (95% CI 86.0% to 97.2%) with revision for any reason as the endpoint. Overall, eight knees (7.5 %) underwent revision surgery during the follow-up. None of the unrevised RHK knees were radiographically loose. The majority of patients evinced good clinical outcome and quality of life as measured with patient reported outcome measures.
The hinge knee replacement which was assessed current study can be regarded as a suitable option in complex primary TKA, provided adequate attention is paid to the correct indications and patient selection.
伴有严重畸形和韧带缺损的复杂初次全膝关节置换术（TKA）的预后尚不清楚。目前文献中关于初次TKA中旋转铰链膝关节假体治疗结果的证据较少。本研究的目的是确定使用单铰链膝关节置换术进行复杂初次TKA的患者的中期临床、影像学和健康相关生活质量（HRQoL）结果。
2004年1月至2013年12月期间，我们机构共使用单旋转铰链膝关节（RHK）假体设计进行了106例复杂初次TKA（101例患者）。我们对这些患者前瞻性收集的结局数据进行了回顾性分析，还从芬兰关节置换登记处获取了所有可能翻修手术的信息，并对所有在世患者进行了前瞻性随访研究。
以任何原因翻修为终点，RHK膝关节的10年Kaplan-Meier生存率为91.6%（95%CI 86.0%至97.2%）。总体而言，8个膝关节（7.5%）在随访期间接受了翻修手术。所有未翻修的RHK膝关节在影像学上均未松动。根据患者报告的结局指标衡量，大多数患者表现出良好的临床结局和生活质量。
本研究评估的铰链膝关节置换术可被视为复杂初次TKA的合适选择，前提是对正确的适应症和患者选择给予足够的关注。
