Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Bone Joint J. 2021 Jun;103-B(6 Supple A):32-37. doi: 10.1302/0301-620X.103B6.BJJ-2020-2096.R1.
Cementless total knee arthroplasty (TKA) offers the potential for strong biological fixation compared with cemented TKA where fixation is achieved by the mechanical integration of the cement. Few mid-term results are available for newer cementless TKA designs, which have used additive manufacturing (3D printing). The aim of this study was to present mid-term clinical outcomes and implant survivorship of the cementless Stryker Triathlon Tritanium TKA.
This was a single institution registry review of prospectively gathered data from 341 cementless Triathlon Tritanium TKAs at four to 6.8 years follow-up. Outcomes were determined by comparing pre- and postoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) scores, and pre- and postoperative 12-item Veterans RAND/Short Form Health Survey (VR/SF-12) scores. Aseptic loosening and revision for any reason were the endpoints which were used to determine survivorship at five years.
At mid-term follow-up, the mean KOOS JR score improved significantly from 33.14 (0 t0 85, standard deviation (SD) 21.88) preoperatively to 84.12 (15.94 to 100, SD 20.51) postoperatively (p < 0.001), the mean VR/SF-12 scores improved significantly from physical health (PH), 31.21 (SD 5.32; 23.99 to 56.77) preoperatively to 42.62 (SD 10.72; 19.38 to 56.82) postoperatively (p < 0.001) and the mental health (MH), 38.15 (SD 8.17; 19.06 to 60.75) preoperatively to 55.09 (SD 9.64; 19.06 to 66.98) postoperatively (p < 0.001). A total of 11 revisions were undertaken, with an overall revision rate of 2.94%, including five for periprosthetic joint infection (1.34%), three for loosening (0.80%), two for instability (0.53%), and one for pain (0.27%). The overall survivorship was 97.06% and survivorship for aseptic loosening as the endpoint was 98.40%, with a 99.5% survivorship of the 3D-printed tibial component.
This 3D-printed cementless total knee system shows excellent survivorship at mid-term follow-up. This design and the ability to obtain cementless fixation offers promise for excellent long-term durability. Cite this article: 2021;103-B(6 Supple A):32-37.
与使用水泥机械整合实现固定的水泥固定相比，无水泥全膝关节置换术（TKA）具有潜在的强大生物学固定作用。对于使用添加剂制造（3D 打印）的较新的无水泥 TKA 设计，中期结果很少。本研究的目的是介绍无水泥史崔克三联钛 Tritanium TKA 的中期临床结果和植入物存活率。
这是一项在四个至六年随访期间对 341 例无水泥 Triathlon Tritanium TKA 的前瞻性收集数据进行的单机构登记研究。通过比较术前和术后膝关节损伤和骨关节炎结果评分（KOOS JR）以及术前和术后 12 项退伍军人 RAND/简短形式健康调查（VR/SF-12）评分来确定结果。无菌性松动和任何原因的翻修为五年时的生存终点。
在中期随访时，KOOS JR 评分从术前的 33.14（0 至 85，标准差（SD）21.88）显著改善至术后的 84.12（15.94 至 100，SD 20.51）（p <0.001），VR/SF-12 评分从身体健康（PH）显著改善，术前 31.21（SD 5.32；23.99 至 56.77）至术后 42.62（SD 10.72；19.38 至 56.82）（p <0.001）和心理健康（MH），术前 38.15（SD 8.17；19.06 至 60.75）至术后 55.09（SD 9.64；19.06 至 66.98）（p <0.001）。共进行了 11 次翻修，总翻修率为 2.94%，包括 5 例因假体周围关节感染（1.34%）、3 例因松动（0.80%）、2 例因不稳定（0.53%）和 1 例因疼痛（0.27%）。总体存活率为 97.06%，以无菌性松动为终点的存活率为 98.40%，3D 打印胫骨组件的存活率为 99.5%。
这种 3D 打印无水泥全膝关节系统在中期随访中表现出优异的存活率。这种设计和获得无水泥固定的能力为优异的长期耐用性提供了希望。
