Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5a, Graz, Austria.
Arch Orthop Trauma Surg. 2023 Feb;143(2):1021-1029. doi: 10.1007/s00402-022-04410-8. Epub 2022 Mar 18.
The aim of this study was to compare the use of mobile-bearing, fixed-bearing, posterior-stabilized (PS) and medial pivot design to describe epidemiological differences and subsequent outcomes.
A systematic literature search was performed using the NORE website to identify the relevant arthroplasty registers. Inclusion criteria were the following: (1) reports had to be publicly available, (2) reports had to be written in German or English language, (3) differentiation between mobile- and fixed-bearing, posterior-stabilized, and if possible, medial pivot designs had to be possible from the present reports, and (4) data had to be reported for at least three consecutive years and the latest report had to be from the year 2020 to retrieve recent data.
Six registries (England and Wales, Australia, Norway, New Zealand, Germany, Switzerland) offered sufficient data according to the inclusion criteria. In all countries, the dominant type of bearing used for total knee arthroplasty (TKA) was fixed-bearing, with percentages ranging from 60.8% to 84.1% in 2018, 63.6% to 85.7% in 2019 and 66.2% to 87.4% in 2020. A large variation was observed concerning mobile-bearing design, which showed a range from 2.8% to 39.2% in 2018, 2.6% to 36.4% in 2019 and 2.9% to 33.8% in 2020. Some variation was found regarding the use of PS TKA, as its percentage frequency ranged from 9.7% to 29.2% in 2018, 9.8% to 29.4% in 2019 and 10.1% to 28.5% in 2020. Medial pivot design had a share of 9.1% in 2018, 8.6% in 2019 and 8.4% in 2020 in Australia, while it only accounted for 1.4% in 2018, 2.1% in 2019 and 2.5% in 2020 in Germany.
The comparison of arthroplasty registers from England and Wales, Australia, Norway, New Zealand, Germany and Switzerland revealed large differences regarding the application of posterior-stabilized designs, but also common ground considering the overwhelming use of fixed-bearing inserts, which, when inserted correctly, eradicate the potential complication of bearing dislocation. Arthroplasty registers offer a real-world clinical perspective with the aim to improve quality and patient safety.
本研究旨在比较使用活动平台、固定平台、后稳定（PS）和内侧枢轴设计来描述流行病学差异和随后的结果。
使用 NORE 网站进行了系统的文献检索，以确定相关的关节置换登记处。纳入标准如下：（1）报告必须公开可用，（2）报告必须用德语或英语书写，（3）从现有报告中必须能够区分活动平台和固定平台、后稳定，如果可能的话，还有内侧枢轴设计，（4）数据必须至少连续三年报告，最新报告必须来自 2020 年，以获取最新数据。
根据纳入标准，有六个登记处（英格兰和威尔士、澳大利亚、挪威、新西兰、德国、瑞士）提供了足够的数据。在所有国家，用于全膝关节置换术（TKA）的主导类型的轴承都是固定平台，2018 年的比例为 60.8%至 84.1%，2019 年为 63.6%至 85.7%，2020 年为 66.2%至 87.4%。活动平台设计的变化很大，2018 年的范围为 2.8%至 39.2%，2019 年为 2.6%至 36.4%，2020 年为 2.9%至 33.8%。后稳定 TKA 的使用也存在一些差异，其百分比频率在 2018 年为 9.7%至 29.2%，2019 年为 9.8%至 29.4%，2020 年为 10.1%至 28.5%。内侧枢轴设计在 2018 年占澳大利亚的 9.1%，2019 年占 8.6%，2020 年占 8.4%，而在德国，2018 年占 1.4%，2019 年占 2.1%，2020 年占 2.5%。
对来自英格兰和威尔士、澳大利亚、挪威、新西兰、德国和瑞士的关节置换登记处的比较表明，在后稳定设计的应用方面存在很大差异，但考虑到固定平台插入物的压倒性使用，也存在共同点，当正确插入时，固定平台插入物消除了轴承脱位的潜在并发症。关节置换登记处提供了一个真实世界的临床视角，旨在提高质量和患者安全。
