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内侧旋转全膝关节置换术适用于膝外翻骨关节炎患者吗?

Is medial pivot total knee arthroplasty suitable for patients with valgus knee osteoarthritis?

作者信息

Iwakiri Kentaro, Ohta Yoichi, Ohyama Yohei, Minoda Yukihide, Kobayashi Akio, Nakamura Hiroaki

机构信息

Department of Orthopaedic Surgery, Shiraniwa Hospital Joint, Arthroplasty Center. 6-10-1 Shiraniwadai Ikoma-city, Nara, 630-0136, Japan.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku Osaka-city, Osaka, 545-8585, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2022 Apr;32(3):551-557. doi: 10.1007/s00590-021-03007-y. Epub 2021 May 27.

DOI:10.1007/s00590-021-03007-y
PMID:34043059
Abstract

PURPOSE

Medial pivot total knee arthroplasty (MP-TKA) is characterized by the ball-in-socket medial tibiofemoral articulation to achieve low wear and to reproduce the medial pivot motion similar to that in the normal knee, and there have been reports of favorable long-term postsurgical outcomes. However, most of these cases concerned varus knees, and the outcomes of MP-TKA in valgus knees are unknown. The objective of this study was to investigate the postoperative outcomes in end-stage valgus knee OA patients who underwent MP-TKA, through comparisons with those who underwent TKA using the same prosthesis for varus deformity.

METHODS

This retrospective, single-center, cohort study analyzed 171 knees of 121 patients who were divided into two groups (valgus knee group: 15 knees (13 patients), varus knee group: 156 knees (109 patients)). Primary outcome measures included the knee joint range of motion (evaluated preoperatively and at every year postoperatively). Secondary outcomes included operative time, laboratory data, estimated blood loss, clinical outcome measures and adverse events.

RESULTS

There were no significant differences in age, sex and body mass index, as well as in the postoperative primary and secondary outcome measures between the two groups.

CONCLUSION

The use of MP-TKA featuring ball-in-socket medial tibiofemoral articulation in patients with valgus knee OA showed equally favorable clinical outcomes more than 2 years after surgery, compared to patients with varus knees who received MP-TKA.

摘要

目的

内侧旋转铰链型全膝关节置换术(MP-TKA)的特点是采用球窝式胫股内侧关节连接,以实现低磨损并重现与正常膝关节相似的内侧旋转运动,并且已有长期术后良好效果的报道。然而,这些病例大多涉及膝内翻,MP-TKA在膝外翻中的效果尚不清楚。本研究的目的是通过与使用相同假体进行膝内翻畸形TKA的患者进行比较,调查接受MP-TKA的终末期膝外翻骨关节炎患者的术后结果。

方法

这项回顾性、单中心队列研究分析了121例患者的171个膝关节,这些患者被分为两组(膝外翻组:15个膝关节(13例患者),膝内翻组:156个膝关节(109例患者))。主要结局指标包括膝关节活动范围(术前及术后每年评估)。次要结局包括手术时间、实验室数据、估计失血量、临床结局指标和不良事件。

结果

两组在年龄、性别和体重指数方面,以及术后主要和次要结局指标方面均无显著差异。

结论

与接受MP-TKA的膝内翻患者相比,膝外翻骨关节炎患者使用具有球窝式胫股内侧关节连接的MP-TKA,术后2年以上显示出同样良好的临床效果。

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