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全膝关节置换术中不同髌骨组件设计的患者报告结局差异:一项随机临床研究。

Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: A randomized clinical study.

机构信息

Department of Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499021996068. doi: 10.1177/2309499021996068.

Abstract

PURPOSE

This study investigated the clinical effects of different patellar components without being affected by the femoral component design in total knee arthritis (TKA) for patients with knee osteoarthritis (OA).

METHODS

In total, 48 patients with OA who met the criteria of the American College of Rheumatology for OA were enrolled and randomly assigned in a 1:1 ratio to two groups according to the usage of patellar component design for TKA (medialized dome type [dome group] or medialized anatomic type [anatomic group]). To evaluate the clinical outcomes for TKA, knee range of motion (ROM), pain intensity of 0-100 mm visual analog scale (pain VAS), and the Japanese Knee Osteoarthritis Measure (JKOM) score were obtained at baseline and year 1.

RESULTS

The difference in knee ROM, pain VAS, or total JKOM score at year 1 was not significant between the dome and anatomic groups ( = 0.398, 0.733 and 0.536, respectively). Moreover, similar results were obtained for changes in knee ROM, pain VAS, or total JKOM scores from baseline. In both groups, the pain VAS and total JKOM scores were significantly improved at year 1.

CONCLUSION

Both dome and anatomic groups in TKA are significantly effective for pain and function using the JKOM score. However, their efficacy did not differ, according to the JKOM score. Results of this study are rare information focusing on the patellar component design and provide one of the insights into the TKA clinical management.

摘要

目的

本研究旨在探讨全膝关节置换术(TKA)中不同髌骨组件对膝骨关节炎(OA)患者的临床效果,不受股骨组件设计的影响。

方法

共纳入符合美国风湿病学会 OA 标准的 48 例 OA 患者,按照 TKA 髌骨组件设计的使用情况(穹顶型[穹顶组]或解剖型[解剖组]),以 1:1 的比例随机分为两组。为评估 TKA 的临床结果,在基线和 1 年时分别测量膝关节活动度(ROM)、0-100mm 视觉模拟量表(疼痛 VAS)疼痛强度和日本膝关节骨关节炎测量(JKOM)评分。

结果

穹顶组和解剖组在 1 年时膝关节 ROM、疼痛 VAS 或总 JKOM 评分的差异均无统计学意义( = 0.398、0.733 和 0.536,分别)。此外,从基线到 1 年时膝关节 ROM、疼痛 VAS 或总 JKOM 评分的变化也有类似结果。两组患者疼痛 VAS 和总 JKOM 评分在 1 年均显著改善。

结论

TKA 中穹顶型和解剖型髌骨组件在使用 JKOM 评分评估疼痛和功能方面均有显著疗效。但根据 JKOM 评分,两者的疗效并无差异。本研究的结果是针对髌骨组件设计的罕见信息,为 TKA 临床管理提供了一些见解。

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