Southwest London Orthopaedic Elective Centre, Epsom General Hospital, Epsom, Surrey, KT18 7EG, UK.
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3411-3418. doi: 10.1007/s00590-023-03565-3. Epub 2023 May 5.
To assess whether there were differences in knee specific function, health related quality of life (HRQoL), and satisfaction between patients with a cruciate retaining (CR) or a posterior stabilised (PS) total knee arthroplasty (TKA) at 1 and 2 years postoperatively.
A retrospective review of TKA (CR and PS) patients from a prospectively collected arthroplasty database. Patient demographics, body mass index and ASA grade, Oxford knee score (OKS) and EuroQol 5-dimension (EQ-5D) 3-level, which was used to assess HRQoL, were collected preoperatively and 1 year and 2 years postoperatively. Regression was used to adjust for confounding factors.
The sample included 3122 TKA, of which 1009 (32.3%) were CR and 2112 (67.7%) were PS. The PS group were more likely to be female (odd ratio (OR) 1.26, p = 0.003) and undergo resurfacing of the patella (OR 6.63, p < 0.001). There was a significantly greater improvement in the 1 year OKS in the PS group (mean difference (MD) 0.9, p = 0.016). The PS TKA was independently associated with a greater 1 year (MD 1.1, 95% CI 0.4 to 1.9, p = 0.001) and 2 years (MD 0.8, p = 0.037) post-operative improvements in OKS. PS TKA was also independently associated with a greater 1 year (MD 0.021, p = 0.024) and 2 years (MD 0.022, p = 0.025) post-operative and change in EQ-5D utility compared to the CR group. The PS group was more likely to be satisfied with their outcome at 1 year (OR 1.75, p < 0.001) and at 2 years (OR 1.38, p = 0.001) when adjusting for confounders.
PS TKA was associated with a better knee specific function and HRQoL when compared to CR, but the clinical significance of this is not clear. However, the PS group was more likely to be satisfied with their outcome compared to the CR group.
评估在膝关节韧带保留（CR）或后稳定（PS）全膝关节置换术（TKA）后 1 年和 2 年，患者的膝关节特定功能、健康相关生活质量（HRQoL）和满意度是否存在差异。
对前瞻性收集的关节置换数据库中的 TKA（CR 和 PS）患者进行回顾性分析。收集患者人口统计学、体重指数和美国麻醉医师协会（ASA）分级、牛津膝关节评分（OKS）和 EuroQol 5 维度（EQ-5D）3 级评分，用于评估 HRQoL，分别在术前和术后 1 年和 2 年进行。采用回归分析来调整混杂因素的影响。
样本包括 3122 例 TKA，其中 1009 例（32.3%）为 CR，2112 例（67.7%）为 PS。PS 组女性患者更多（优势比（OR）1.26，p=0.003），髌骨表面置换术（OR 6.63，p<0.001）的比例更高。PS 组在术后 1 年的 OKS 评分显著提高（平均差值（MD）0.9，p=0.016）。PS TKA 与术后 1 年（MD 1.1，95%可信区间 0.4 至 1.9，p=0.001）和 2 年（MD 0.8，p=0.037）OKS 评分的改善独立相关。PS TKA 还与术后 1 年（MD 0.021，p=0.024）和 2 年（MD 0.022，p=0.025）EQ-5D 效用的变化独立相关，与 CR 组相比，PS 组的满意度更高。在调整混杂因素后，PS 组在术后 1 年（OR 1.75，p<0.001）和 2 年（OR 1.38，p=0.001）时更有可能对结果感到满意。
与 CR 相比，PS TKA 与更好的膝关节特定功能和 HRQoL 相关，但这一临床意义尚不清楚。然而，与 CR 组相比，PS 组对其结果更满意。
