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INBONE II 假体翻修全踝关节置换术的临床和影像学结果。

Clinical and Radiographic Outcomes of Revision Total Ankle Arthroplasty Using the INBONE II Prosthesis.

机构信息

Foot and Ankle Unit, Nottingham Elective Orthopaedics, Nottingham University Hospitals, Nottingham, United Kingdom.

出版信息

J Bone Joint Surg Am. 2022 Sep 7;104(17):1554-1562. doi: 10.2106/JBJS.21.01240. Epub 2022 Jun 28.

Abstract

BACKGROUND

The literature on the outcome of revision total ankle arthroplasty (TAA) remains limited. In this study, we aimed to report the clinical and radiographic outcomes of revision TAA at a high-volume center in the United Kingdom.

METHODS

This study was a retrospective review of 28 patients who underwent 29 revision TAAs using the INBONE II Total Ankle System (Wright Medical Technology/Stryker). Demographic, radiographic, and patient-reported outcome measure data were analyzed.

RESULTS

The mean duration from primary TAA to revision was 87.5 months (range, 16 to 223 months). The main indication for the revision was aseptic loosening after the primary TAA (83%). Additional procedures were required in 76% of ankles. At a mean follow-up of 40 months (range, 24 to 60 months), the infection rate was 7%, the reoperation rate was 7%, and the implant survival rate was 97%. A significant postoperative improvement in the radiographic component alignment measures was observed. The subsidence, loosening, and heterotopic ossification rates in this study were comparable with those in other reports and did not influence the clinical outcome. A significant improvement was observed in the Manchester-Oxford Foot Questionnaire (MOXFQ) in all domains and the EuroQol-5 Dimensions (EQ-5D) in 3 domains at 24 months postoperatively.

CONCLUSIONS

Revision TAA using the INBONE II prosthesis was associated with good short-term survival and improvement in postoperative scores at 2 years. Maintenance of the postoperatively improved alignment was documented at the follow-up. The results of this study support the notion that revision TAA is a satisfactory option for failed primary TAA.

LEVEL OF EVIDENCE

Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

关于翻修全踝关节置换术(TAA)的结果的文献仍然有限。在本研究中,我们旨在报告英国一家高容量中心翻修 TAA 的临床和影像学结果。

方法

这是一项回顾性研究,共纳入 28 例患者,共 29 例采用 INBONE II 全踝关节系统(Wright Medical Technology/Stryker)进行翻修。分析了人口统计学、影像学和患者报告的结果测量数据。

结果

初次 TAA 至翻修的平均时间为 87.5 个月(范围,16 至 223 个月)。翻修的主要指征是初次 TAA 后无菌性松动(83%)。76%的踝关节需要额外的手术。平均随访 40 个月(范围,24 至 60 个月)时,感染率为 7%,再次手术率为 7%,假体生存率为 97%。术后影像学组件对线测量有显著改善。本研究中的沉降、松动和异位骨化率与其他报告相似,且不影响临床结果。术后 24 个月时,曼彻斯特-牛津足部问卷(MOXFQ)所有领域和欧洲五维健康量表(EQ-5D)的 3 个领域的评分均显著改善。

结论

采用 INBONE II 假体进行翻修 TAA 具有良好的短期生存率,并在术后 2 年改善了评分。在随访时记录了术后改善对线的维持情况。本研究结果支持翻修 TAA 是治疗初次 TAA 失败的一种满意选择的观点。

证据水平

治疗性 IV 级。请参阅作者指南以获取完整的证据水平描述。

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