Rajgopal Ashok, Kumar Sumit, Aggarwal Kalpana
Institute of Musculoskeletal Disorders and Orthopaedics, Medanta-The Medicity Hospital Gurugram, Haryana, 122001 India.
Indian J Orthop. 2021 Jul 26;55(5):1180-1185. doi: 10.1007/s43465-021-00460-z. eCollection 2021 Oct.
Total Knee Arthroplasty (TKA) is the gold standard of treatment for end stage arthritis not responding to conservative treatment. With a recent increase in the younger population presenting with osteoarthritis (OA) we undertook this study to evaluate long-term outcomes and survivorship of TKA in this cohort.
Our study cohort included 328 patients, < 55 years, with OA, who underwent TKA using Cruciate Retaining (CR), and Posterior Stabilized (PS) implants with a minimum follow up of 15 years. Revision surgery was the end point of our analysis and Kaplan-Meier evaluation of survivorship was measured. Knee Society Scores (KSS) and Range of Motion (ROM) were assessed to evaluate outcomes.
Survivorship of the CR and PS implants with revision as end point, for aseptic loosening was 97.3% and 96%, and revision for all causes was 89.7% and 86.1%, respectively, at 15 years. The outcomes of CR implants were better than the PS cohort in terms of function and survivorship.
Long term survivorship and outcome analysis of TKA in patients < 55 years showed good results with excellent survivorship, with both CR and PS implants. The CR cohort demonstrated better long-term survivorship, though the difference was not statistically significant. Deep infection and aseptic loosening were the commonest causes for failure.
全膝关节置换术（TKA）是终末期关节炎保守治疗无效时的金标准治疗方法。随着近期患骨关节炎（OA）的年轻人群数量增加，我们开展了这项研究，以评估该队列中TKA的长期疗效和假体生存率。
我们的研究队列包括328例年龄小于55岁的OA患者，他们接受了保留交叉韧带（CR）和后稳定型（PS）假体的TKA手术，且至少随访15年。翻修手术是我们分析的终点，并采用Kaplan-Meier法评估假体生存率。评估膝关节协会评分（KSS）和活动范围（ROM）以评价疗效。
以翻修为终点，15年时CR和PS假体因无菌性松动的生存率分别为97.3%和96%，因各种原因翻修的生存率分别为89.7%和86.1%。CR假体在功能和生存率方面的疗效优于PS队列。
对年龄小于55岁患者的TKA长期生存率和疗效分析显示结果良好，CR和PS假体的生存率均很高。CR队列显示出更好的长期生存率，尽管差异无统计学意义。深部感染和无菌性松动是最常见的失败原因。
