Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2325-2330. doi: 10.1007/s00590-022-03422-9. Epub 2022 Nov 10.
The purpose of this study is to assess the short-term survivorship of a new uncemented TKA design in a high-volume centre to evaluate the safety of this design prior to widespread adoption.
We performed a retrospective cohort study of all primary TKAs (cemented and uncemented) between May 2018 and May 2019. Primary outcome variables included aseptic revision, all-cause revision, time to revision, operative time and radiological outcomes. Predictor variables considered included age, gender, BMI, ASA, implant type (cruciate-retaining, posterior-stabilised or totally-stabilised) and the use of cemented or uncemented implants.
There were 300 cemented TKAs and 249 uncemented TKAs (Triathlon, Stryker Inc., Mahwah, NJ) implanted. The mean follow-up for all cases was 31.6 months (minimum follow-up 2 years). Of the entire 549 implants only 4 were revised. Two of these were for infection, 1 was for patellar maltracking and 1 was for knee stiffness. All 4 revisions occurred in the cemented cohort. The aseptic revision rate in the cemented cohort was 0.7% compared to 0.0% in the uncemented cohort (p = 0.298). Operative times were significantly reduced in the uncemented cohort from 57.9 to 51.7 min (p < 0.001). There were 8/300 (2.6%) patients with RLLs in the cemented cohort and 4/249 (1.6%) patients with RLLs in the uncemented cohort (p = 0.56).
The uncemented Triathlon TKA demonstrates excellent survivorship at short-term follow-up when compared to the cemented Triathlon TKA, thus eliminating any potential clinical concerns with this novel implant in the early post-operative phase.
本研究旨在评估高容量中心新型非骨水泥 TKA 设计的短期生存率,以评估该设计在广泛应用前的安全性。
我们对 2018 年 5 月至 2019 年 5 月期间所有初次 TKA(骨水泥固定和非骨水泥固定)进行了回顾性队列研究。主要观察结果变量包括无菌性翻修、全因翻修、翻修时间、手术时间和影像学结果。考虑的预测变量包括年龄、性别、BMI、ASA、植入物类型(交叉韧带保留、后稳定或完全稳定)以及骨水泥固定或非骨水泥固定植入物的使用。
共植入 300 例骨水泥 TKA 和 249 例非骨水泥 TKA(Stryker Inc.,美国新泽西州 Mahwah 的 Triathlon)。所有病例的平均随访时间为 31.6 个月(最短随访时间 2 年)。在 549 个植入物中,只有 4 个进行了翻修。其中 2 例因感染,1 例因髌骨脱位,1 例因膝关节僵硬而翻修。所有 4 例翻修均发生在骨水泥组。骨水泥组的无菌性翻修率为 0.7%,而非骨水泥组为 0.0%(p=0.298)。非骨水泥组的手术时间从 57.9 分钟显著缩短至 51.7 分钟(p<0.001)。骨水泥组有 8/300(2.6%)患者发生 RLL,非骨水泥组有 4/249(1.6%)患者发生 RLL(p=0.56)。
与骨水泥固定的 Triathlon TKA 相比,非骨水泥固定的 Triathlon TKA 在短期随访时具有优异的生存率,因此消除了该新型植入物在术后早期阶段的任何潜在临床担忧。