Kemker Bernard P, Sowers Christopher B, Seedat Raees, Satpathy Jibanananda, Patel Nirav K, Lombardo Daniel J, Golladay Gregory J
Department of Orthopaedic Surgery, VCU Health, Richmond, VA, United States.
Virginia Commonwealth University, School of Medicine, Richmond, VA, United States.
Front Surg. 2022 Mar 11;9:716510. doi: 10.3389/fsurg.2022.716510. eCollection 2022.
Hybrid fixation and fully cemented fixation are commonly used in revision total knee arthroplasty (rTKA). These two techniques are typically done based on surgeon preference and one has not demonstrated superiority over the other. The purpose of this study was to examine if there was a difference in survivorship between the two different techniques.
A retrospective cohort study of all consecutive patients undergoing rTKA (CPT 27487) from January 1, 2011 to January 1, 2018 at a single academic center was performed. Patients were divided into cemented and hybrid rTKA groups with comparison of patient demographic, clinical and radiological outcomes, reoperation, change in post-operative hemoglobin (HgB), and length of stay (LOS).
A total of 133 rTKA for 122 patients were identified: 30.1% in the cemented and 69.9% in the hybrid groups. There was no significant difference in age ( = 0.491), sex ( = 0.250), laterality ( = 0.421), or body mass index (BMI) ( = 0.609) between the two groups. Mean LOS (hybrid 4.13 days, cemented 3.65 days; = 0.356) and change in Hgb (hybrid 2.95 mg/dL, cemented 2.62mg/dL; = 0.181) were not statistically different between the groups. Mean follow up for the hybrid (25.4 months, range 2-114 months) and cemented (24.6 months, range 3-75.5 months) rTKA was not statistically significant ( = 0.825). Overall survival rates were 80.9% in the hybrid and 84.6% in the cemented groups ( = 0.642).
Hybrid and fully cemented rTKA techniques have similar survival rates at a minimum followup of 2 years. Additionally, in our cohort, age, gender, and BMI were not associated with failure in either group. Furthermore, we did not observe differences in LOS or change in hemoglobin suggesting early postoperative complications may not differ between cemented and hybrid stemmed groups. Continued long-term research is required for defining the best rTKA technique.
混合固定和全骨水泥固定常用于翻修全膝关节置换术（rTKA）。这两种技术通常根据外科医生的偏好进行，且尚未证明其中一种优于另一种。本研究的目的是检验这两种不同技术在生存率上是否存在差异。
对2011年1月1日至2018年1月1日在单一学术中心接受rTKA（CPT 27487）的所有连续患者进行回顾性队列研究。患者被分为骨水泥固定和混合rTKA组，比较患者的人口统计学、临床和放射学结果、再次手术、术后血红蛋白（HgB）变化以及住院时间（LOS）。
共确定了122例患者的133例rTKA：骨水泥固定组占30.1%，混合组占69.9%。两组在年龄（P = 0.491）、性别（P = 0.250）、侧别（P = 0.421）或体重指数（BMI）（P = 0.609）方面无显著差异。两组之间的平均住院时间（混合组4.13天，骨水泥固定组3.65天；P = 0.356）和血红蛋白变化（混合组2.95mg/dL，骨水泥固定组2.62mg/dL；P = 0.181）无统计学差异。混合rTKA（25.4个月，范围2 - 114个月）和骨水泥固定rTKA（24.6个月，范围3 - 75.5个月）的平均随访时间无统计学意义（P = 0.825）。混合组的总体生存率为80.9%，骨水泥固定组为84.6%（P = 0.642）。
在至少2年的随访中，混合和全骨水泥rTKA技术的生存率相似。此外，在我们的队列中，年龄、性别和BMI与两组中的失败均无关。此外，我们未观察到住院时间或血红蛋白变化的差异，提示骨水泥固定组和混合柄组术后早期并发症可能无差异。需要持续进行长期研究以确定最佳的rTKA技术。
