Carulli Christian, Innocenti Matteo, Tambasco Rinaldo, Perrone Alessandro, Civinini Roberto
Orthopaedic Clinic, University of Florence, 50139 Florence, Italy.
J Clin Med. 2023 Jun 28;12(13):4356. doi: 10.3390/jcm12134356.
(1) Background: Total Knee Arthroplasty (TKA) in patient with haemophilia (PWH) has usually been performed with the use of cobalt-chrome femoral and titanium tibial components, coupled with standard polyethylene (PE) inserts. The aim of this retrospective study was to evaluate the long-term outcomes and survival rates of TKA in a series of consecutive PWH affected by severe knee arthropathy at a single institution. (2) Methods: We followed 65 patients undergoing 91 TKA, implanted using the same implant, characterized by an oxidized zirconium femoral component, coupled with a titanium tibial component, and a highly crosslinked PE. At 1, 6, and 12 months; then every year for 5 years; and finally, every other 3 years, all patients were scored for pain (VAS), function (HJHS; KSS), ROM, and radiographic changes. Kaplan-Meier survivorship curves were used to calculate the implant survival rates. (3) Results: The mean follow-up was 12.3 years (4.2-20.6). All clinical and functional scores improved significantly from preoperatively to the latest follow-up (VAS: from 6.9 to 1.3; HJHS: from 13.4 to 1.9; KSS: from 19.4 to 79; ROM: from 42.4° to 83.6°). The overall survivorship of the implants was 97.5% at the latest follow-up. (4) Conclusions: The present series showed a high survival rate of specific implants potentially linked to the choice of an oxidized zirconium coupled with a highly crosslinked PE. We promote the use of modern implants in these patients in order to ensure long-lasting positive outcomes.
(1)背景:血友病患者(PWH)的全膝关节置换术(TKA)通常使用钴铬合金股骨部件和钛合金胫骨部件,并搭配标准聚乙烯(PE)内衬进行。本回顾性研究的目的是评估在单一机构中,一系列患有严重膝关节病的连续性PWH患者接受TKA的长期疗效和生存率。(2)方法:我们对65例接受91次TKA手术的患者进行了随访,这些手术均使用相同的植入物,其特点是采用氧化锆股骨部件、钛合金胫骨部件以及高度交联的PE。在术后1、6和12个月;然后连续5年每年进行评估;最后,每3年进行一次评估,对所有患者进行疼痛(VAS)、功能(HJHS;KSS)、活动度(ROM)和影像学变化评分。采用Kaplan-Meier生存曲线计算植入物生存率。(3)结果:平均随访时间为12.3年(4.2 - 20.6年)。从术前到最近一次随访,所有临床和功能评分均显著改善(VAS:从6.9降至1.3;HJHS:从13.4降至1.9;KSS:从19.4升至79;ROM:从42.4°升至83.6°)。在最近一次随访时,植入物的总体生存率为97.5%。(4)结论:本系列研究显示,特定植入物的高生存率可能与氧化锆与高度交联PE的选择有关。我们提倡在这些患者中使用现代植入物,以确保长期的积极疗效。