Maciąg Bartosz M, Stolarczyk Artur, Maciąg Grzegorz J, Dorocińska Monika, Stępiński Piotr, Szymczak Jakub, Świercz Maciej, Żarnovsky Krystian, Łapiński Marcin, Stolarczyk Magda
Department of Orthopedics and Rehabilitation, Medical University of Warsaw, Warsaw, Poland.
3rd Clinic of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
Arthroplast Today. 2021 Nov 1;12:62-67. doi: 10.1016/j.artd.2021.09.001. eCollection 2021 Dec.
Total knee arthroplasty (TKA) is considered the most efficient treatment of end-stage osteoarthritis. There is an ongoing debate about proper implant designs and articulation types. One of the considered causes of unsatisfactory outcome and patients' dissatisfaction is femoral or tibial component overhanging, which can lead to chronic knee pain and restricted motion. The aim of this study is to compare radiological outcomes of TKA using an anatomic PERSONA Posterior-Stabilized (PS) knee design with its nonanatomic predecessor, the NexGen LPS.
A group of 39 patients who received the PERSONA PS system and 33 patients who received the NexGen LPS was included. PERSONA patients were matched to NexGen patients using a 0.1 propensity score threshold with priority given to exact matches. Anteroposterior, lateral, and long-leg radiographs were taken preoperatively and at 6 weeks postoperatively to perform radiological and statistical analysis.
The PERSONA subgroup had statistically higher posterior condylar offset. There is no statistically significant difference in posterior condylar offset ratio. There were less cases of femoral notching, femoral overhang, and placing tibial baseplate in the medial overhang in the PERSONA PS subgroup than in the NexGen subgroup (each statistically significant). Occurrence of tibial underhang was not statistically significant.
Radiological assessment in short-term follow-up showed excellent results for PERSONA knee design with better fit to native femur and tibia. In comparison to its predecessor, it also spares more bone tissue. As the aforementioned parameters are risk factors of lesser clinical outcomes, the PERSONA design gives high hopes for improvement of TKA satisfaction rate.
全膝关节置换术（TKA）被认为是终末期骨关节炎最有效的治疗方法。关于合适的植入物设计和关节连接类型的争论一直存在。结果不尽人意和患者不满意的一个原因被认为是股骨或胫骨部件悬垂，这可能导致慢性膝关节疼痛和活动受限。本研究的目的是比较采用解剖型PERSONA后稳定（PS）膝关节设计的TKA与非解剖型前代产品NexGen LPS的放射学结果。
纳入一组39例接受PERSONA PS系统的患者和33例接受NexGen LPS的患者。使用0.1的倾向评分阈值将PERSONA患者与NexGen患者进行匹配，优先考虑完全匹配。术前和术后6周拍摄前后位、侧位和长腿X线片，进行放射学和统计学分析。
PERSONA亚组的后髁偏移在统计学上更高。后髁偏移率无统计学显著差异。与NexGen亚组相比，PERSONA PS亚组的股骨切迹、股骨悬垂和胫骨基板内侧悬垂的病例更少（均具有统计学显著性）。胫骨悬垂的发生率无统计学显著性。
短期随访的放射学评估显示，PERSONA膝关节设计效果极佳，与天然股骨和胫骨的贴合度更好。与前代产品相比，它还能保留更多的骨组织。由于上述参数是临床结果较差的风险因素，PERSONA设计为提高TKA满意度带来了很高的期望。
