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常规与导航辅助初次全膝关节置换术治疗重度内翻膝的生存率和疗效比较:至少 10 年随访。

Comparison of Survival Rate and Outcomes Between Conventional and Navigation-Assisted Primary Total Knee Arthroplasty in Severe Varus Knees: A Minimum 10-Year Follow-Up.

机构信息

Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyangsi, Gyeonggido, South Korea.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

J Arthroplasty. 2022 Nov;37(11):2164-2170. doi: 10.1016/j.arth.2022.05.038. Epub 2022 May 23.

Abstract

BACKGROUND

This study aimed to compare the long-term clinical and radiographic outcomes and survival rates between navigation-assisted (NAV) total knee arthroplasty (TKA) and conventional (CON) TKA in patients with preoperative severe varus deformity.

METHODS

From January 2005 to December 2011, 152 TKAs and 62 TKAs with preoperative hip-knee-ankle (HKA) angles more than 15° were enrolled in the CON-TKA and NAV-TKA group with 135.7 months follow-up. Clinical outcomes (Western Ontario and McMaster University Osteoarthritis Index and Knee Society Scores), radiographic outcomes (HKA, α, β, γ, and δ angles), and survivorship were compared between the groups.

RESULTS

The mean value of radiographic outcomes was not statistically different; however, outliers of the HKA angle were significantly higher in the CON-TKA group (18.4% versus 8.1%, P = .04). However, long-term clinical outcomes were similar between both groups. The cumulative survival rate was 96.1% in the CON-TKA group and 96.8% in the NAV-TKA group, with no difference between the groups (P = .962).

CONCLUSION

NAV-TKA showed fewer outliers in the HKA angle for severe preoperative varus deformity compared with CON-TKA. The long-term clinical outcomes and survival rates were similar between the 2 techniques. A survival rate of more than 96% was observed in both groups.

STUDY DESIGN

Level III, retrospective comparative study.

摘要

背景

本研究旨在比较导航辅助(NAV)全膝关节置换术(TKA)与传统(CON)TKA 治疗术前重度内翻畸形患者的长期临床和影像学结果及生存率。

方法

2005 年 1 月至 2011 年 12 月,CON-TKA 组和 NAV-TKA 组分别纳入了 152 例和 62 例术前髋膝踝角(HKA)大于 15°的 TKA 患者,随访时间为 135.7 个月。比较两组的临床结果(西部安大略省和麦克马斯特大学骨关节炎指数和膝关节协会评分)、影像学结果(HKA、α、β、γ和δ角)和生存率。

结果

影像学结果的平均值无统计学差异;然而,CON-TKA 组的 HKA 角离群值明显更高(18.4%比 8.1%,P=0.04)。然而,两组的长期临床结果相似。CON-TKA 组的累积生存率为 96.1%,NAV-TKA 组为 96.8%,两组间无差异(P=0.962)。

结论

与 CON-TKA 相比,NAV-TKA 治疗术前重度内翻畸形时 HKA 角的离群值更少。两种技术的长期临床结果和生存率相似。两组的生存率均超过 96%。

研究设计

III 级回顾性比较研究。

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