Kotrych Daniel, Marcinkowski Sławomir, Brodecki Adam, Anuszkiewicz Marcin, Kleszowski Jakub, Bohatyrewicz Andrzej, Ciechanowicz Dawid
Department of Children Orthopaedics and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin 71-281, >Poland.
Department of Orthopedics, Specialist Orthopedic and Rehabilitation Hospital "Gorka," Busko Zdroj, Poland.
Open Med (Wars). 2022 Jul 15;17(1):1292-1298. doi: 10.1515/med-2022-0494. eCollection 2022.
Revision procedures and the resulting bone loss are a big challenge for orthopedic surgeons. Therefore, we checked what functional outcomes that 3D-printed cone augments can offer to patients with bone defects (Anderson Orthopedic Research Institute [AORI] classification type 2B and 3) in the knee and whether the use of cones can delay the necessity to use a megaprotheses. Data from 64 patients ( = 22; = 42) who underwent total knee arthroplasty (TKA) revision were included in the analysis. The Knee Society Clinical Rating System (KSS) and the range of motion in the knee joint were used for the functional assessment. The mean follow-up was 28 months (range: 18-44 months). The survival rate for aseptic loosening at follow-up was 100%. Infection occurred in two (3.1%) patients. The mean KSS score increased from 12.75 points preoperatively to 66.56 postoperatively ( < 0.001). The mean range of motion in the knee changed from 61.15° preoperatively to 115.93° postoperatively ( < 0.001). 3D-printed cone augments seem to be a good solution for patients requiring a TKA revision procedure. When used in patients with bone defects classified as 2B and 3 (AORI), they can be a good alternative, delaying the need for megaprotheses.
翻修手术及由此导致的骨质流失对骨科医生来说是一项巨大挑战。因此,我们研究了3D打印锥形增强物能为膝关节存在骨缺损(安德森骨科研究所[AORI]分类为2B型和3型)的患者带来怎样的功能预后,以及使用锥形增强物是否能推迟使用大型假体的必要性。分析纳入了64例行全膝关节置换术(TKA)翻修的患者的数据(男性 = 22例;女性 = 42例)。采用膝关节协会临床评分系统(KSS)和膝关节活动范围进行功能评估。平均随访时间为28个月(范围:18 - 44个月)。随访时无菌性松动的生存率为100%。2例(3.1%)患者发生感染。KSS平均评分从术前的12.75分增至术后的66.56分(P < 0.001)。膝关节平均活动范围从术前的61.15°变为术后的115.93°(P < 0.001)。对于需要进行TKA翻修手术的患者,3D打印锥形增强物似乎是一个不错的解决方案。当用于AORI分类为2B型和3型骨缺损的患者时,它们可以是一个很好的替代方案,可推迟大型假体的使用需求。