Baek Ji-Hoon, Lee Su Chan, Ryu Suengryol, Ahn Hye Sun, Nam Chang Hyun
Joint & Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Himnaera Hospital, Busan, Republic of Korea.
Orthop Res Rev. 2022 Jun 9;14:199-206. doi: 10.2147/ORR.S365377. eCollection 2022.
The purpose of this study was to assess the medium-term results of trabecular metal cones for the reconstruction of large bone defects in revision TKA.
Thirteen patients who had undergone revision TKA using trabecular metal cones for femoral and/or tibial large bone defects were identified. We included patients who had a minimum of three years follow-up in the study. We evaluated their functional outcomes, implant survivorship, radiological findings, and complications.
At a mean follow-up of 6.9 years (range of 3.5-9.4 years), all trabecular metal cones and implants were well fixed and did not exhibit any radiographic evidence of migration or loosening. At the final follow-up, the mean Knee Society knee scores had improved from 37.2 to 78.1 (p < 0.05), and function scores had improved from 35.5 to 77.5 points (p < 0.05). One intraoperative fracture in the distal femur occurred in an 85-year-old woman during impaction of a single trabecular metal cone. The fracture was successfully affixed to the femoral cone and bone three months postoperatively.
The present study of trabecular metal cones demonstrates excellent clinical outcomes and survivorship in revision TKA during medium-term follow-up periods. However, longer-term follow-up studies are needed to further investigate these implants in revision TKA. Additionally, the necessity of metal cones in revision procedures should be carefully considered depending on patient needs and economic capabilities.
本研究旨在评估小梁金属锥体用于翻修全膝关节置换术(TKA)中大型骨缺损重建的中期结果。
确定了13例使用小梁金属锥体进行股骨和/或胫骨大型骨缺损翻修TKA的患者。我们纳入了至少随访三年的患者。我们评估了他们的功能结果、植入物生存率、影像学表现和并发症。
平均随访6.9年(范围3.5 - 9.4年),所有小梁金属锥体和植入物固定良好,没有任何影像学证据表明有移位或松动。在最后随访时,膝关节协会膝关节平均评分从37.2提高到78.1(p < 0.05),功能评分从35.5提高到77.5分(p < 0.05)。一名85岁女性在植入单个小梁金属锥体时发生股骨远端术中骨折。骨折在术后三个月成功固定于股骨锥体和骨上。
本研究中关于小梁金属锥体的结果表明,在中期随访期间,翻修TKA具有出色的临床结果和生存率。然而,需要进行长期随访研究以进一步研究这些植入物在翻修TKA中的情况。此外,应根据患者需求和经济能力仔细考虑翻修手术中使用金属锥体的必要性。