Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.
Arch Orthop Trauma Surg. 2023 Aug;143(8):5293-5301. doi: 10.1007/s00402-023-04763-8. Epub 2023 Jan 10.
Kinematically designed total knee arthroplasty (TKA) aims to restore normal kinematics by replicating the function of both cruciate ligaments. Traditional posterior-stabilized (PS) TKA designs, on the other hand, simplify knee kinematics and may improve TKA cost-effectiveness. The purpose of this study was to compare outcomes of patients who underwent primary TKA using either a traditional PS or kinematically designed TKA.
This retrospective study examined all patients who underwent primary TKA using either a kinematically or a traditional PS designed TKA implant, with a minimum follow-up of 2 years. Patient demographics, complications, readmissions, revision rates and causes, range of motion (ROM) and patient reported outcomes (KOOS, JR) were compared between groups. Kaplan-Meier survivorship analysis was performed to estimate freedom from revision, and multivariate regression was performed to control for confounding variables.
A total of 396 TKAs [173 (43.7%) with a kinematic design, 223 (56.3%) with a traditional design] with a mean follow-up of 3.48 ± 1.51 years underwent analysis. Revision rates did not differ between groups (9.8% vs. 6.7%, p = 0.418). In Kaplan-Meier analysis at 2-year follow-up, freedom from all-cause revision (96.4% vs. 93.1%, p = 0.139) were similar between groups. The two cohorts had no significant difference in aseptic loosening at 2 years (99.6% vs. 97.1, p = 0.050) and at latest follow up (92.7% vs. 96.4%, p = 0.279). KOOS, JR scores and post-operative ROM were similar between groups.
This study demonstrated similar mid-term outcomes following the use of both a kinematically designed and a traditionally designed implant in primary TKA patients.
Retrospective study-III.
运动学设计的全膝关节置换术（TKA）旨在通过复制前后交叉韧带的功能来恢复正常的运动学。另一方面，传统的后稳定型（PS）TKA 设计简化了膝关节的运动学，并且可能提高 TKA 的成本效益。本研究的目的是比较使用传统 PS 或运动学设计的 TKA 的患者的结果。
本回顾性研究检查了所有接受使用运动学或传统 PS 设计的 TKA 植入物的初次 TKA 的患者，随访时间至少为 2 年。比较了两组患者的人口统计学资料、并发症、再入院率、翻修率和原因、关节活动度（ROM）和患者报告的结果（KOOS、JR）。使用 Kaplan-Meier 生存分析估计无翻修率，并进行多元回归以控制混杂变量。
共分析了 396 例 TKA [173 例（43.7%）采用运动学设计，223 例（56.3%）采用传统设计]，平均随访 3.48±1.51 年。两组的翻修率无差异（9.8%比 6.7%，p=0.418）。Kaplan-Meier 分析显示，在 2 年随访时，两组的全因翻修无差异（96.4%比 93.1%，p=0.139）。两组在 2 年时无菌性松动的发生率无显著差异（99.6%比 97.1%，p=0.050）和在末次随访时（92.7%比 96.4%，p=0.279）。KOOS、JR 评分和术后 ROM 两组间相似。
本研究表明，在初次 TKA 患者中，使用运动学设计和传统设计的植入物具有相似的中期结果。
回顾性研究 III 级。
