Singapore General Hospital, Singapore.
J Orthop Surg (Hong Kong). 2021 Sep-Dec;29(3):23094990211055224. doi: 10.1177/23094990211055224.
BackgroundPosterior stabilized (PS) total knee arthroplasty (TKA) is advocated in severe varus osteoarthritic (OA) knees as the posterior cruciate ligament posed challenges in gap balancing. However, there is scarcity in the literature to illustrate the superiority of PS TKA over cruciate retaining (CR) TKA. Our study aims to compare the outcomes between CR and PS TKAs in patients with severe varus OA knees. A retrospective review was conducted on patients who underwent primary TKA for OA knee from 2003 to 2013. Patients with OA knees of varus tibiofemoral angle ≥15 were matched into two groups (Group CR and PS) according to age, gender, and body mass index and compared in terms of clinical (tibiofemoral alignment, range of motion, and revision rate) and functional outcome (Knee Society Scoring, Oxford Knee Score, Short Form-36 Health Survey). Both Group CR ( = 56) and PS ( = 56) had similar pre-operative scores. Both groups achieved correction of tibiofemoral alignment from median pre-operative varus of 17.6/17.0 (CR/PS) ( = .279) to median post-operative valgus of 4.9/4.0 (CR/PS) ( = .408). Over 24 months, both groups were comparable in achieving significant improvement in clinical and functional outcomes. No case of revision surgery was reported (median follow-up months; CR: 65, PS: 74, = .549). Both CR and PS TKAs perform similarly well in severe varus OA knee up to 2 years post-operation. Further studies are warranted to assess the long-term outcome between the two implant designs.
在严重内翻型骨关节炎(OA)膝关节中,提倡使用后稳定型(PS)全膝关节置换术(TKA),因为后交叉韧带在间隙平衡方面存在挑战。然而,文献中很少有研究表明 PS TKA 优于保留交叉韧带(CR)TKA。我们的研究旨在比较严重内翻型 OA 膝关节患者中 CR 和 PS TKA 的结果。
对 2003 年至 2013 年接受初次 TKA 治疗 OA 膝关节的患者进行回顾性研究。根据年龄、性别和体重指数将 OA 膝关节内翻胫骨股骨角≥15°的患者分为两组(CR 组和 PS 组),并比较两组的临床(胫骨股骨对线、活动范围和翻修率)和功能结果(膝关节协会评分、牛津膝关节评分、健康调查简表-36)。
CR 组( = 56)和 PS 组( = 56)的术前评分相似。两组均从术前平均内翻 17.6/17.0(CR/PS)( =.279)纠正为术后平均外翻 4.9/4.0(CR/PS)( =.408)。在 24 个月内,两组在临床和功能结果方面均取得了显著改善。没有报告翻修手术的病例(中位随访时间;CR:65 个月,PS:74 个月, =.549)。
在严重内翻型 OA 膝关节中,CR 和 PS TKA 在术后 2 年内的表现相似。需要进一步研究来评估两种植入物设计之间的长期结果。