Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France.
IFSTTAR, LBMC UMR_T9406, University of Lyon, Claude Bernard Lyon 1 University, 69622, Lyon, France.
Knee Surg Sports Traumatol Arthrosc. 2022 Aug;30(8):2854-2861. doi: 10.1007/s00167-021-06716-3. Epub 2021 Sep 2.
The aim of the study was to compare clinical and radiological outcomes between primary and aseptic revision TKAs using the same posterior-stabilised (PS) prosthesis. The authors hypothesised similar outcomes between both groups for selected patients.
This retrospective, case-control study assessed 36 patients who underwent aseptic revision TKA compared to a match group of 72 primary TKA. Both groups had the same PS design implant (ANATOMIC®, Amplitude, Valence, France). The International Knee Society (IKS) score, radiological outcomes (postoperative alignment, patellar tilt and radiolucent lines), re-intervention and revision rate were compared between the two groups with a minimum follow-up of 3 years.
The final study cohort included 29 patients and 63 patients respectively in the revision and primary group, with a mean follow-up of 49.1 months (range 36.1-69). Postoperatively, there was no significant difference in IKS scores between the two groups [169.8 for the revision group and 179.6 for the primary group (p = 0.09)]. No statistical difference was observed for post-operative satisfaction 86.2% versus 92.1% (p = 0.46). Between the two groups, there was no difference in mean radiological assessment, including radiolucent lines (p = 0.7). There was no significant difference for overall implant survivorship 96.5% versus 100% (p = 0.13) at 36 months.
Similar clinical, radiological and survivorship outcomes were found between rTKA and primary TKA groups using the same PS level of constraint in patients undergoing revision surgery for aseptic indications at 3-year follow-up. Use of PS implants in rTKA for the correct indication suggests this to be a safe approach at least in the medium term.
IV, retrospective case-control study.
本研究旨在比较初次全膝关节置换术（TKA）和同一后稳定型（PS）假体行初次翻修 TKA 的临床和影像学结果。作者假设对于特定患者，两组的结果相似。
本回顾性病例对照研究评估了 36 例因无菌性原因行初次翻修 TKA 的患者，并与一组 72 例初次 TKA 患者进行了匹配。两组均使用相同的 PS 设计假体（ANATOMIC ® ，Amplitude，Valence，法国）。使用国际膝关节协会（IKS）评分、影像学结果（术后对线、髌骨倾斜和透亮线）、再次干预和翻修率对两组进行比较，随访时间至少 3 年。
最终研究队列包括翻修组和初次组各 29 例和 63 例患者，平均随访时间为 49.1 个月（36.1-69）。术后，两组的 IKS 评分无显著差异[翻修组为 169.8，初次组为 179.6（p=0.09）]。术后满意度分别为 86.2%和 92.1%，差异无统计学意义（p=0.46）。两组的平均影像学评估，包括透亮线，差异无统计学意义（p=0.7）。在 36 个月时，两组的总体假体生存率分别为 96.5%和 100%，差异无统计学意义（p=0.13）。
在 3 年随访时，对于因无菌性原因行初次翻修 TKA 的患者，使用相同 PS 水平限制的假体，初次 TKA 和翻修 TKA 组的临床、影像学和生存率结果相似。对于正确适应证的翻修 TKA 使用 PS 假体提示这是一种安全的方法，至少在中期是这样。
IV，回顾性病例对照研究。
