Suppr超能文献

全膝关节置换术与部分膝关节置换术翻修的无菌比较。

Comparison of Aseptic Partial- and Full-Component Revision Total Knee Arthroplasty.

机构信息

NYU Langone Health, Department of Orthopedic Surgery, New York, New York; Division of Orthopedic Surgery, Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

NYU Langone Health, Department of Orthopedic Surgery, New York, New York.

出版信息

J Arthroplasty. 2023 Jul;38(7 Suppl 2):S360-S368. doi: 10.1016/j.arth.2022.09.025. Epub 2022 Nov 8.

Abstract

BACKGROUND

Revision total knee arthroplasty (rTKA) can be performed with isolated tibial, isolated femoral, and combined tibial and femoral component exchange for different indications. Replacement of only 1 fixed component in rTKA leads to shorter operative times and decreased complexity. We sought to compare functional outcomes and rates of rerevision in patients undergoing partial and full rTKA.

METHODS

This retrospective study examined all aseptic rTKA patients with a minimum follow-up of 2 years in a single center between September 2011 and December 2019. Patients were divided into two groups: full rTKA (F-rTKA) if both components (femoral and tibial) were revised and partial rTKA (P-rTKA) if only 1 component was revised. A total of 293 patients (P-rTKA = 76, F-rTKA = 217) were included.

RESULTS

P-rTKA patients had significantly shorter surgical time (109 ± 37 Versus. 141 ± 44 minutes, P < .001). At mean follow-up of 4.2 (range 2.2-6.2) years, rerevision rates did not significantly differ between groups (11.8 Versus. 16.1%, P = .358). Improvements in postoperative Visual Analogue Scale (VAS) pain and Knee Injury and Osteoarthritis Scale (KOOS), Joint Replacement scores were similar as well (P = .100 and P = .140, respectively). For patients undergoing rTKA due to aseptic loosening, freedom from rerevision due to aseptic loosening was similar between groups (100 Versus. 97.8%, P = .321). For patients undergoing rTKA due to instability, freedom from rerevision due to instability did not significantly differ as well (100 Versus. 98.1%, P = .683). In the P-rTKA cohort, freedom from all-cause and aseptic revision of preserved components was 96.1% and 98.7% at the 2-year follow-up.

CONCLUSION

Compared to F-rTKA, P-rTKA yielded similar functional outcomes and implant survivorship with shorter surgical time. When indications and component compatibility allow for such a procedure, surgeons can expect good outcomes when performing P-rTKA.

摘要

背景

翻修全膝关节置换术(rTKA)可分别采用单纯胫骨、单纯股骨或同时行胫骨和股骨组件置换来治疗不同的适应证。rTKA 中仅更换 1 个固定组件可缩短手术时间并降低手术复杂性。我们旨在比较部分和全翻修 rTKA 患者的功能结局和再次翻修率。

方法

本回顾性研究纳入了 2011 年 9 月至 2019 年 12 月在单中心接受至少 2 年随访的所有无菌性 rTKA 患者。患者分为两组:若同时更换股骨和胫骨两个组件则为全翻修 rTKA(F-rTKA),若仅更换 1 个组件则为部分翻修 rTKA(P-rTKA)。共纳入 293 例患者(P-rTKA=76 例,F-rTKA=217 例)。

结果

P-rTKA 患者的手术时间明显更短(109±37 分钟比 141±44 分钟,P<0.001)。在平均 4.2 年(2.2-6.2 年)的随访中,两组的再次翻修率无显著差异(11.8%比 16.1%,P=0.358)。术后视觉模拟评分(VAS)疼痛和膝关节损伤和骨关节炎评分(KOOS)、关节置换评分的改善也相似(P=0.100 和 P=0.140)。对于因无菌性松动而行 rTKA 的患者,因无菌性松动而再次翻修的无失败率在两组间相似(100%比 97.8%,P=0.321)。对于因不稳定而行 rTKA 的患者,因不稳定而再次翻修的无失败率也无显著差异(100%比 98.1%,P=0.683)。在 P-rTKA 队列中,在 2 年随访时,保留组件的全因和无菌性翻修无失败率分别为 96.1%和 98.7%。

结论

与 F-rTKA 相比,P-rTKA 可获得相似的功能结局和假体生存率,且手术时间更短。当适应证和组件兼容性允许时,外科医生行 P-rTKA 可获得良好的效果。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验