Vertesich Klemens, Staats Kevin, Böhler Christoph, Koza Richard, Lass Richard, Giurea Alexander
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Front Bioeng Biotechnol. 2022 Mar 4;10:845859. doi: 10.3389/fbioe.2022.845859. eCollection 2022.
The use of rotating hinge (RH) prostheses for severe primary as well as revision arthroplasty is widely established. Due to the steadily increasing number of RH prostheses, we aimed to assess the complication frequencies, complication types and clinical outcomes of a modern RH hinge prosthesis using a new bearing material with a minimum follow-up of 7 years. Fifty-six consecutive patients who received the EnduRo RH prosthesis using carbon-fiber reinforced poly-ether-ether-ketone (CFR-PEEK) as bearing material were included in this prospective study: 21 patients (37.5%) received the prosthesis as a primary total knee arthroplasty (TKA) and 35 patients (62.5%) underwent revision total knee arthroplasties (rTKA). Clinical and radiographic examinations were performed preoperatively, postoperatively after three and 12 months and annually thereafter. Clinical scores were documented for each patient. Competing risk analysis was assessed with respect to indication and failure mode. Knee Society Score (KSS), Western Ontario and McMaster Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS) and range of motion (ROM) improved significantly compared to preoperative values ( < 0.0001). The overall cumulative incidence for revision surgery was 23.6% at 7 years and the cumulative incidence for complications associated with failure of the prothesis was 5.6% at 7 years, respectively. Complications occurred more frequently in the revision group ( = 0.002). The evaluated RH prosthesis provided reliable and durable results for a minimum follow-up of 7 years. Prosthesis survival was successful considering the complexity of the cases. The use of this RH system in primary patients showed high survival rates and long-term functional outcomes and clinical outcomes proved to be satisfying in both revision and primary cases. No adverse events were associated with the new bearing material CFR-PEEK.
旋转铰链（RH）假体在严重原发性关节置换以及翻修关节置换术中的应用已广泛确立。由于RH假体的数量不断增加，我们旨在评估一种采用新型轴承材料的现代RH铰链假体的并发症发生率、并发症类型和临床结果，最小随访时间为7年。本前瞻性研究纳入了56例连续接受以碳纤维增强聚醚醚酮（CFR-PEEK）为轴承材料的EnduRo RH假体的患者：21例患者（37.5%）接受该假体作为初次全膝关节置换术（TKA），35例患者（62.5%）接受翻修全膝关节置换术（rTKA）。术前、术后3个月和12个月以及此后每年进行临床和影像学检查。记录每位患者的临床评分。针对适应证和失败模式进行竞争风险分析。与术前值相比，膝关节协会评分（KSS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、牛津膝关节评分（OKS）和活动范围（ROM）均有显著改善（<0.0001）。7年时翻修手术的总体累积发生率为23.6%，假体失败相关并发症的累积发生率为5.6%。并发症在翻修组中更频繁发生（=0.002）。评估的RH假体在最小随访7年的时间里提供了可靠且持久的结果。考虑到病例的复杂性，假体存活情况良好。在原发性患者中使用这种RH系统显示出高存活率，长期功能结果和临床结果在翻修和原发性病例中均令人满意。没有与新型轴承材料CFR-PEEK相关的不良事件。
