Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.
ReSurg SA, Rue Saint Jean 22, 1260, Nyon, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):1001-1024. doi: 10.1007/s00167-021-06507-w. Epub 2021 Mar 4.
To summarise the literature on 3rd-condyle total knee arthroplasty (TKA) designs and compare their survival rates to those of post-cam TKA designs. The null hypothesis was that 3rd-condyle TKAs would have equivalent survival rates compared to contemporary post-cam TKAs.
An electronic literature search for Level I-V studies was independently conducted by two researchers using Medline and Web of Science for studies published between January 1984 and October 2020 that specifically reported on rates of implant survival and complications, joint kinematics, clinical outcomes, and radiographic outcomes of 3rd-condyle TKA. The methodological quality of clinical studies was assessed according to the Downs and Black Quality Checklist for Health Care Intervention Studies, and for in vitro and in silico studies according to the Joanna Briggs Institute (JBI) tool for assessing analytical cross-sectional studies. Findings extracted for each TKA design were presented as reported and synthesised narratively. Survival rates at 5, 10 and > 10 years of 3rd-condyle TKA designs were graphically compared to rates of post-cam TKA designs published in joint registries.
A total of 38 studies were identified that reported on kinematics, clinical outcomes, radiographic alignment, and rates of complications and survival. Mean survival rates ranged from 96 to 98% at 5 years, 78-100% at 5-10 years, and 86-99% at > 10 years for 3rd-condyle PS TKAs. Mean survival rates ranged from 93 to 98% at 5 years, 89-99% at 5-10 years, and 88-95% at > 10 years for post-cam PS TKAs.
Implant survival rates of 3rd-condyle TKAs are comparable to those of post-cam TKAs at follow-up > 10 years. When compared to post-cam PS TKA, 3rd-condyle designs offer an alternative for younger and more active patients when considering the added benefits of a lowered point-of-contact and larger congruent contact area at the intercondylar tibial sulcus, that reduce risks of loosening and component wear.
V.
总结关于第三髁全膝关节置换术（TKA）设计的文献，并将其生存率与后凸轮 TKA 设计进行比较。零假设是第三髁 TKA 的生存率与当代后凸轮 TKA 相当。
两位研究人员使用 Medline 和 Web of Science 独立进行了电子文献检索，检索了 1984 年 1 月至 2020 年 10 月期间发表的特定报告第三髁 TKA 植入物存活率和并发症、关节运动学、临床结果以及影像学结果的 I-V 级研究。根据健康护理干预研究的唐斯和布莱克质量检查表评估临床研究的方法学质量，根据乔安娜布里格斯研究所（JBI）用于评估分析性横截面研究的工具评估体外和计算研究的方法学质量。为每种 TKA 设计提取的研究结果以报告形式呈现并进行了叙述性综合。第三髁 TKA 设计的 5、10 和>10 年生存率与关节登记处报告的后凸轮 TKA 设计的生存率进行了图形比较。
共确定了 38 项研究，这些研究报告了运动学、临床结果、影像学对准以及并发症和生存率。第三髁 PS TKA 的 5 年平均生存率为 96-98%，5-10 年为 78-100%，>10 年为 86-99%。后凸轮 PS TKA 的 5 年平均生存率为 93-98%，5-10 年为 89-99%，>10 年为 88-95%。
在随访>10 年时，第三髁 TKA 的植入物生存率与后凸轮 TKA 相当。与后凸轮 PS TKA 相比，当考虑到降低的接触点和在髁间胫骨沟处更大的一致接触面积带来的附加益处时，第三髁设计为年轻且更活跃的患者提供了另一种选择，这些益处降低了松动和组件磨损的风险。
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