Frye Benjamin M, Patton Caitlyn, Kinney Jason A, Murphy T Ryan, Klein Adam E, Dietz Matthew J
Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.
West Virginia University School of Medicine, Morgantown, WV, USA.
Arthroplast Today. 2021 Jan 19;7:243-249.e0. doi: 10.1016/j.artd.2020.11.003. eCollection 2021 Feb.
Although a successful operation, almost 20% of patients are dissatisfied with total knee arthroplasty (TKA). The purpose of this retrospective cohort study was to see if a medial congruent (MC) polyethylene would offer satisfactory early outcomes and patient satisfaction after TKA.
We reviewed prospectively collected data on 327 TKAs using multiple bearings within the same implant system. Ninety-six received an MC bearing, 70 received a cruciate-retaining (CR) bearing, and 161 received a posterior-stabilized (PS) bearing. We evaluated the visual analog scale pain scores and range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 1 year; Patient-Reported Outcomes Measurement Information System (PROMIS-10) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 months and 1 year; and Forgotten Joint Score (FJS-12) at 1 year.
All groups had similar KOOS and PROMIS-10 scores. MC knees had lower visual analog scale scores than PS knees at all time points ( < .05) and a higher ROM than PS at 2 weeks (98.6 vs 93.7, = .002). MC knees had a significantly higher FJS-12 than CR knees (71.6 vs 58.7, = .02). More MC knees were "very satisfied" than CR (92.6% vs 81.5%, = .04). Fewer MC knees were "not at all satisfied" than CR (1.2% vs 9.2%, = .04). There were similar satisfaction ratings with MC and PS.
An MC bearing provided similar or improved early pain, ROM, KOOS, PROMIS-10, FJS-12, and patient satisfaction as compared with standard bearings in TKA.
尽管全膝关节置换术(TKA)手术成功,但仍有近20%的患者对该手术不满意。这项回顾性队列研究的目的是探讨内侧匹配(MC)聚乙烯在TKA术后是否能提供令人满意的早期疗效及患者满意度。
我们回顾了前瞻性收集的327例使用同一植入系统中多种衬垫的TKA数据。96例接受MC衬垫,70例接受保留交叉韧带(CR)衬垫,161例接受后稳定型(PS)衬垫。我们评估了2周、6周、3个月和1年时的视觉模拟量表疼痛评分及活动范围(ROM);3个月和1年时的患者报告结局测量信息系统(PROMIS-10)评分及膝关节损伤和骨关节炎结局评分(KOOS);以及1年时的遗忘关节评分(FJS-12)。
所有组的KOOS和PROMIS-10评分相似。MC膝关节在所有时间点的视觉模拟量表评分均低于PS膝关节(P<0.05),且在2周时的ROM高于PS膝关节(98.6对93.7,P = 0.002)。MC膝关节的FJS-12显著高于CR膝关节(71.6对58.7,P = 0.02)。与CR膝关节相比,更多接受MC膝关节置换的患者“非常满意”(92.6%对81.5%,P = 0.04)。接受MC膝关节置换的患者“完全不满意”的比例低于CR膝关节(1.2%对9.2%,P = 0.04)。MC和PS的满意度评级相似。
与TKA中的标准衬垫相比,MC衬垫在早期疼痛、ROM、KOOS、PROMIS-10、FJS-12及患者满意度方面提供了相似或更好的效果。