Joint Implant Surgeons, Inc, New Albany, Ohio, USA.
Department of Orthopedics, OhioHealth, Columbus, USA.
Bone Joint J. 2021 Jun;103-B(6 Supple A):145-149. doi: 10.1302/0301-620X.103B6.BJJ-2020-2051.R1.
A limited number of investigations with conflicting results have described perivascular lymphocytic infiltration (PVLI) in the setting of total knee arthroplasty (TKA). The purpose of this study was to determine if PVLI found in TKAs at the time of aseptic revision surgery was associated with worse clinical outcomes and survivorship.
A retrospective review was conducted on 617 patients who underwent aseptic TKA revision who had histological analysis for PVLI at the time of surgery. Clinical and radiological data were obtained pre- and postoperatively, six weeks postoperatively, and then every year thereafter.
Within this cohort, 118 patients (19.1%) were found to have PVLI on histological analysis. Re-revision was performed on 83 patients (13.4%) with no significant differences in all-cause or aseptic revisions between groups. A higher incidence of PVLI was noted in female patients (p = 0.037). There was no significant difference in improvement in the range of motion (p = 0.536), or improvement of KSC (p = 0.66), KSP (p = 0.61), or KSF (p = 0.3) clinical outcome scores between PVLI and no PVLI sub-groups. There was a higher incidence of a preoperative diagnosis of pain in the PVLI group compared with patients without PVLI (p = 0.002) present.
PVLI found on large-scale histological analysis in TKAs at aseptic revision surgery was not associated with worse clinical outcomes or rates of re-revision. Cite this article: 2021;103-B(6 Supple A):145-149.
少数研究结果存在争议,这些研究描述了全膝关节置换术(TKA)时血管周围淋巴细胞浸润(PVLI)。本研究旨在确定在无菌翻修手术时 TKA 中发现的 PVLI 是否与更差的临床结果和生存率有关。
对 617 例接受无菌 TKA 翻修术且术中进行 PVLI 组织学分析的患者进行回顾性研究。术前、术后 6 周及术后每年均获得临床和影像学数据。
在该队列中,118 例(19.1%)患者在组织学分析中发现有 PVLI。83 例(13.4%)患者行再次翻修,两组间全因或无菌翻修无显著差异。女性患者的 PVLI 发生率较高(p = 0.037)。PVLI 组和无 PVLI 组在运动范围改善(p = 0.536)、KSC(p = 0.66)、KSP(p = 0.61)或 KSF(p = 0.3)临床结局评分改善方面无显著差异。PVLI 组术前疼痛诊断的发生率高于无 PVLI 组(p = 0.002)。
在无菌翻修手术时,TKA 中大范围组织学分析发现的 PVLI 与较差的临床结果或再翻修率无关。