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Delta 医疗的 PEEK 界面螺钉与 Endobutton 以及 Smith & Nephew 的在关节镜下前交叉韧带重建中的安全性和有效性比较:一项多中心前瞻性双盲随机对照临床试验。

The safety and effectiveness comparison of Delta Medical's PEEK interface screw and Endobutton and that of Smith & Nephew's in arthroscopic anterior cruciate ligament reconstruction: A multicenter prospective double-blind randomized controlled clinical trial.

机构信息

Department of Joint Surgery and Sports Medicine, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, China.

Clinical Research Center for Sports Medicine in Hunan Province, Changsha, China.

出版信息

Front Public Health. 2022 Nov 7;10:1003591. doi: 10.3389/fpubh.2022.1003591. eCollection 2022.

Abstract

BACKGROUND

To reduce the costs and financial burden in the ACLR treatment, we compare the early clinical outcomes and Magnetic Resonance Imaging (MRI) results of Delta Medical's PEEK (polyether ether ketone) interference screw and EndoButton with those of Smith & Nephew's PEEK interference screw and EndoButton in patients with arthroscopic anterior cruciate ligament reconstruction.

METHODS

A total of 104 patients in five different medical centers were randomly allocated into two groups: 1: Delta Medical's PEEK interference screw and EndoButton (53 patients); 2: Smith & Nephew's PEEK interference screw and EndoButton (51 patients). The modified Lysholm knee score, the laxity examination, and clinical and functional range of motion were evaluated at 3 and 6 months postoperatively. The clinical effective rate was calculated and classified as excellent and good at 6 months postoperatively. MRI examinations were performed at 3 and 6 months postoperatively to determine the healing process. Computerized tomography (CT) was performed at 2 weeks and 3 months postoperatively to evaluate the complications.

RESULTS

Significant improvements in knee function and functional scores were observed in both groups after surgery regardless of the fixation materials applied ( < 0.05). No differences were observed in the functional scores and range of motion. The assessments of Lysholm knee scores at 3 and 6 months produced no statistical differences (both > 0.05). The clinical effective rate revealed no difference between the groups at 6 months postoperatively (non-inferiority analysis = 0.0220). The differences of laxity examination between the groups were not statistically significant (Fisher's test, = 0.6139, 0.2004, respectively). No significant differences in the functional range of motion were found at each follow-up time-point ( > 0.05). No major intra- or postoperative complications, such as infection, and vessel or nerve injury were observed.

CONCLUSIONS

Knee function and functional scores were improved after ACLR in both groups, regardless of the PEEK interference screw and EndoButton applied. The difference in functional scores and range of motion were not significant in groups 1 and 2. Delta Medical's PEEK interference screw and EndoButton had a non-inferiority effect compared to Smith & Nephew's PEEK interference screw and EndoButton. Delta Medical's PEEK interference screw and EndoButton were suitable for arthroscopic ACLR.

摘要

背景

为了降低 ACLR 治疗的成本和经济负担,我们比较了 Delta Medical 的 PEEK(聚醚醚酮)干扰螺钉和 EndoButton 与 Smith & Nephew 的 PEEK 干扰螺钉和 EndoButton 在关节镜前交叉韧带重建患者中的早期临床结果和磁共振成像(MRI)结果。

方法

共有来自五个不同医疗中心的 104 名患者被随机分为两组:1:Delta Medical 的 PEEK 干扰螺钉和 EndoButton(53 例);2:Smith & Nephew 的 PEEK 干扰螺钉和 EndoButton(51 例)。术后 3 个月和 6 个月时,采用改良 Lysholm 膝关节评分、松弛检查和临床及功能活动范围进行评估。术后 6 个月计算临床有效率并分为优、良。术后 3 个月和 6 个月行 MRI 检查,确定愈合过程。术后 2 周和 3 个月行 CT 检查,评估并发症。

结果

两组患者术后膝关节功能和功能评分均有显著改善(均 < 0.05),与固定材料无关。两组功能评分和活动范围无差异。术后 3 个月和 6 个月的 Lysholm 膝关节评分评估无统计学差异(均 > 0.05)。术后 6 个月两组临床有效率无差异(非劣效性分析 = 0.0220)。两组松弛检查差异无统计学意义(Fisher 检验,= 0.6139,= 0.2004)。各随访时间点的功能活动范围无显著差异(均 > 0.05)。未观察到感染、血管或神经损伤等主要的围手术期并发症。

结论

两组患者 ACLR 后膝关节功能和功能评分均有改善,与应用 PEEK 干扰螺钉和 EndoButton 无关。组 1 和组 2 之间的功能评分和活动范围无显著差异。与 Smith & Nephew 的 PEEK 干扰螺钉和 EndoButton 相比,Delta Medical 的 PEEK 干扰螺钉和 EndoButton 具有非劣效性。Delta Medical 的 PEEK 干扰螺钉和 EndoButton 适用于关节镜下 ACLR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/946f/9676447/0129a816d701/fpubh-10-1003591-g0001.jpg

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