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非骨水泥型与骨水泥型全膝关节置换术:一项前瞻性随机对照试验的简明中期结果。

Cementless Versus Cemented Total Knee Arthroplasty: Concise Midterm Results of a Prospective Randomized Controlled Trial.

机构信息

Department of Orthopedic Surgery, Washington University in St. Louis, St. Louis, Missouri.

出版信息

J Bone Joint Surg Am. 2023 Sep 20;105(18):1430-1434. doi: 10.2106/JBJS.23.00161. Epub 2023 Jun 22.

Abstract

BACKGROUND

We previously reported the 2-year results of a prospective randomized controlled trial of cementless versus cemented total knee arthroplasty (TKA) implants of the same design. The purpose of the present study was to provide concise results at intermediate-term follow-up.

METHODS

The original study included 141 TKAs (76 performed without cement and 65 performed with cement). Since then, 8 patients died and 4 withdrew. Of the remaining 129 patients, 127 (98%) were available for analysis. Survivorship analysis was performed; Oxford Knee, Knee Society, and Forgotten Joint Scores were calculated; and radiographs reviewed. Mean follow-up was 6 years.

RESULTS

The survivorship free of any revision was 100% in both groups. There were no differences between the groups in any patient-reported functional outcome measure (p = 0.2 to 0.5). However, a higher percentage of patients in the cementless TKA group were either extremely or very satisfied with their overall function (p = 0.01). Radiographically, there was no evidence of implant loosening in either group.

CONCLUSIONS

At 6 years, there were no differences between cementless and cemented TKA implants of the same design in terms of survivorship, clinical, or radiographic outcomes.

LEVEL OF EVIDENCE

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

我们之前报告了一项前瞻性随机对照试验的 2 年结果,该试验比较了相同设计的非骨水泥固定与骨水泥固定全膝关节置换术(TKA)植入物。本研究的目的是在中期随访时提供简洁的结果。

方法

原始研究纳入了 141 例 TKA(76 例未使用骨水泥,65 例使用骨水泥)。此后,8 例患者死亡,4 例退出。在剩余的 129 例患者中,127 例(98%)可用于分析。进行了生存分析;计算了牛津膝关节评分、膝关节学会评分和遗忘关节评分;并对 X 线片进行了评估。平均随访时间为 6 年。

结果

两组均无任何翻修的生存率为 100%。两组在任何患者报告的功能结果测量指标(p=0.2 至 0.5)方面均无差异。然而,非骨水泥 TKA 组中有更高比例的患者对其整体功能非常满意或满意(p=0.01)。X 线片上,两组均未见植入物松动的证据。

结论

在 6 年时,相同设计的非骨水泥固定与骨水泥固定 TKA 植入物在生存率、临床或影像学结果方面没有差异。

证据水平

治疗学级别 I。请参阅作者说明以获取完整的证据级别描述。

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