Department of Orthopaedics, Dr SN Medical College Jodhpur, Jodhpur, India.
Department of Orthopaedics, Star Hospitals, B Block, Banjara Hills, Hyderabad, India.
Arch Orthop Trauma Surg. 2023 Dec;143(12):7139-7146. doi: 10.1007/s00402-023-05000-y. Epub 2023 Aug 2.
New total knee prostheses are being designed to improve clinical outcome, survivorship and patient satisfaction following total knee arthroplasty (TKA). A new knee system was developed with improvements in patellofemoral joint, trochlear geometry, polyethylene formulation and tibial baseplate. Aim of this study was to compare the newer kinematic knee system with its existing predecessor knee system in terms of clinical outcome, revision rates, radiographic outcomes specifically medial tibial bone resorption.
The prospective matched-pair study included 88 TKA surgeries using newer kinematic design knee prostheses, performed between January 2015 and December 2016, out of which 82 patients were available for final follow-up. The control cohort of 82 traditional TKA prosthesis was matched in terms of age, gender and body mass index. All surgeries were performed by the single surgeon using medial parapatellar arthrotomy and posterior stabilized implants were used. Clinical outcomes were assessed using knee society score, range of motion (ROM), anterior knee pain and crepitation. Radiological examinations included recording of radiolucent lines and medial tibial bone resorption.
At the 5-year follow-up, no significant differences were noted in terms of mean knee society score (93.3 ± 6.6 vs 94.2 ± 8.1), knee function score (88.5 ± 10.5 vs 89.1 ± 11.2) and ROM. The incidences of anterior knee pain and crepitation were lower in the newer group (8.5% vs 21.9% and 14.6% vs 32.9%, respectively) compared to the traditional prosthesis group. No cases of aseptic loosening were observed in either cohort. No significant difference was seen in terms of radiolucent lines (29.3% vs 26.8%) and medial tibial resorption (2.43% in each group) incidences.
At the 5 years follow-up no significant differences were noted between the two groups in terms of clinical and radiological outcomes, except the former proved to be better for anterior knee pain and crepitation.
II.
新的全膝关节假体被设计用来改善全膝关节置换术后的临床结果、存活率和患者满意度。一种新的膝关节系统在髌股关节、滑车几何形状、聚乙烯配方和胫骨基板方面进行了改进。本研究的目的是比较新型运动学膝关节系统与其现有的前一代膝关节系统在临床结果、翻修率、影像学结果（特别是内侧胫骨骨吸收）方面的差异。
这项前瞻性配对研究纳入了 2015 年 1 月至 2016 年 12 月间使用新型运动学设计膝关节假体的 88 例 TKA 手术，其中 82 例患者可获得最终随访。对照组 82 例采用传统 TKA 假体，匹配年龄、性别和体重指数。所有手术均由同一位外科医生采用内侧髌旁入路进行，使用后稳定型植入物。临床结果采用膝关节学会评分、活动范围（ROM）、前膝疼痛和弹响进行评估。影像学检查包括记录透亮线和内侧胫骨骨吸收。
在 5 年随访时，两组在平均膝关节学会评分（93.3±6.6 与 94.2±8.1）、膝关节功能评分（88.5±10.5 与 89.1±11.2）和 ROM 方面无显著差异。新型组的前膝疼痛和弹响发生率较低（分别为 8.5%与 21.9%和 14.6%与 32.9%）。两组均未发现无菌性松动。两组在透亮线（29.3%与 26.8%）和内侧胫骨吸收（每组 2.43%）发生率方面无显著差异。
在 5 年随访时，两组在临床和影像学结果方面无显著差异，除了新型组在前膝疼痛和弹响方面表现更好。
II 级。
