Department of Orthopedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands.
Department of Orthopedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands; Orthopedic Department, Xpert Clinics, Amsterdam, The Netherlands.
J Arthroplasty. 2024 Feb;39(2):363-367. doi: 10.1016/j.arth.2023.08.050. Epub 2023 Aug 19.
Total knee arthroplasty (TKA) for post-traumatic arthritis (PTA) poses higher challenges and increased risks of complications compared to TKA for osteoarthritis (OA). This study aimed to compare implant survivorships, reasons for revision, and patient-reported outcome measures between OA and PTA as indications for TKA.
We selected all primary TKAs for PTA or OA between 2007 and 2020 from the Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies). The study included 3,897 TKA procedures for PTA (median follow-up 4.6 years; interquartile range: 2.2, 7.3) and 255,259 procedures for OA (median follow-up 4.7 years; interquartile range 2.2, 7.6). A total of 10,480 revision procedures were performed across both groups (238 in PTA knees; 10,242 in OA knees). We analyzed the prevalence of preoperative comorbidities and postoperative complications, as well as the reasons for revision, and calculated the implant survival rates.
The survival revision rate in the OA group was significantly lower at both follow-up moments (5- and 10- years). The likelihood for revision was increased in TKA for PTA compared to TKA for OA (hazards ratio: 1.16 [95% confidence interval 1.02 to 1.33], P = .03). The most common reason for a revision was instability and arthrofibrosis in the PTA group compared to patellar pain for the OA group.
This study demonstrated an increased risk for revision for any reason in TKA for PTA compared to OA. Revision for instability and arthrofibrosis were more prevalent in the PTA group, while revision for patellar pain was less prevalent compared to TKA for OA.
与骨关节炎（OA）相比，创伤后关节炎（PTA）行全膝关节置换术（TKA）具有更高的挑战和增加并发症的风险。本研究旨在比较 PTA 和 OA 作为 TKA 适应证的假体生存率、翻修原因和患者报告的结果测量指标。
我们从荷兰关节置换登记处（Landelijke Registratie Orthopedische Interventies）中选择了 2007 年至 2020 年间所有 PTA 或 OA 的初次 TKA。该研究包括 3897 例 PTA（中位数随访 4.6 年；四分位距 2.2，7.3）和 255259 例 OA（中位数随访 4.7 年；四分位距 2.2，7.6）的 TKA 手术。两组共进行了 10480 例翻修手术（PTA 膝关节 238 例；OA 膝关节 10242 例）。我们分析了术前合并症和术后并发症的发生率、翻修原因，并计算了假体生存率。
OA 组在两个随访时间点（5 年和 10 年）的翻修生存率显著较低。与 OA 相比，PTA 的 TKA 翻修的可能性增加（风险比：1.16 [95%置信区间 1.02 至 1.33]，P =.03）。PTA 组最常见的翻修原因是不稳定和关节纤维化，而 OA 组最常见的翻修原因是髌骨疼痛。
与 OA 相比，PTA 的 TKA 有更高的任何原因翻修风险。PTA 组不稳定和关节纤维化的翻修更为常见，而 OA 组髌骨疼痛的翻修则较少。
