Meding John B, Meding Lindsey K, Meneghini R Michael, Williams Timothy J
Center for Hip and Knee Surgery, St. Francis Hospital Mooresville, Mooresville, Indiana.
Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana; IU Hip and Knee Center, Fishers, Indiana.
J Arthroplasty. 2022 Jun;37(6S):S238-S244. doi: 10.1016/j.arth.2022.01.038. Epub 2022 Feb 20.
Ultracongruent (UC) tibial bearings are being used with increasing frequency in the United States. Evidence suggests that the use of certain UC bearings may lead to improved patient satisfaction when compared with using conventional inserts. However, little is known as to what effect the use of UC tibial inserts has on bone ingrowth in uncemented total knee arthroplasty (TKA). The purpose of this study was to determine the early clinical and radiographic results of TKA using a press-fit dual-pivot design.
Between 2017 and 2019, a consecutive series of 232 TKAs were implanted using a press-fit tibial and femoral component and a UC dual-pivot tibial insert. Sixty-two percent of patients were male. The average age was 56 years. Patients were followed for a minimum of 2 years (range, 24-42 months) using KOOS-JR and Knee Society clinical and radiographic evaluation.
No patient had more than mild knee stiffness at the final follow-up. Two patients reported moderate knee pain with stair climbing. All other patients reported either mild or no pain with activity. Knee Society pain scores averaged 42 points. Flexion averaged 118 degrees. Three knees (1.3%) were revised (one each for flexion instability, tibial plateau fracture, and suspected femoral component loosening). No other cases of femoral or tibial loosening were identified.
Although the success of uncemented TKA is determined by a variety of factors, the use of this dual-pivot knee design did not appear to influence tibial or femoral component fixation at early follow-up, yielding acceptable clinical and radiographic outcomes.
在美国，超匹配（UC）胫骨衬垫的使用频率越来越高。有证据表明，与使用传统衬垫相比，使用某些UC衬垫可能会提高患者满意度。然而，关于UC胫骨衬垫的使用对非骨水泥全膝关节置换术（TKA）中骨长入的影响，人们知之甚少。本研究的目的是确定使用压配双轴设计的TKA的早期临床和影像学结果。
在2017年至2019年期间，连续植入了232例使用压配胫骨和股骨组件以及UC双轴胫骨衬垫的TKA。62%的患者为男性。平均年龄为56岁。使用KOOS-JR以及膝关节协会的临床和影像学评估对患者进行了至少2年（范围为24至42个月）的随访。
在最后一次随访时，没有患者的膝关节僵硬程度超过轻度。两名患者报告在爬楼梯时有中度膝关节疼痛。所有其他患者报告活动时疼痛轻微或无疼痛。膝关节协会疼痛评分平均为42分。屈曲平均为118度。三个膝关节（1.3%）进行了翻修（分别因屈曲不稳定、胫骨平台骨折和疑似股骨组件松动）。未发现其他股骨或胫骨松动病例。
尽管非骨水泥TKA的成功取决于多种因素，但在早期随访中，这种双轴膝关节设计的使用似乎并未影响胫骨或股骨组件的固定，产生了可接受的临床和影像学结果。
