Minamoto Sandra Tie Nishibe, Mozella Alan de Paula, Cossich Victor Rodrigues Amaral, Gavilão Ubiratã Faleiro, Machado Heitor Schuabb, Barretto João Maurício
Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil.
Grupo de Joelho do Hospital São Vicente, Rede D'Or, Rio de Janeiro, RJ, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Mar 21;59(1):e68-e75. doi: 10.1055/s-0044-1779685. eCollection 2024 Feb.
: To compare the function and muscle strength of the limb between patients undergoing knee arthroplasties using primary implants with posterior stabilization (control group) and patients with rotating hinge implants (Hinge group). : Function assessment was performed using the Knee Society Score (KSS) and muscle strength using an isokinetic dynamometer using a speed of 60°/s. : 43 patients were analyzed, who underwent 51 surgeries, with the Hinge group comprising 25 surgeries and the control group comprising 26 primary surgeries. We did not observe significant differences between the Hinge and control groups in the values of functional KSS (p = 0.54), objective KSS (p = 0.91), peak flexor torque (p = 0.25) and peak extensor torque (p = 0.08). Patients in the Hinge group who underwent primary arthroplasties had a higher peak flexor torque (0.76 Nm/kg) than those who used the implant in revision after septic failure (0.33 Nm/kg) (p < 0.05). The constrained implant was indicated in arthroplasty revision surgeries with severe ligament instability and in cases of complex primary arthroplasties with bone destruction or severe coronal deformity in the coronal plane. : The use of constrained implants enables joint function and muscle strength comparable to patients who underwent primary arthroplasty using conventional implants with posterior stabilization. Patients undergoing septic revision with a rotating Hinge prosthesis exhibit lower flexor muscle strength compared to those undergoing primary arthroplasty with a constrained implant.
比较使用后稳定型初次植入物进行膝关节置换术的患者（对照组）与使用旋转铰链植入物的患者（铰链组）之间肢体的功能和肌肉力量。使用膝关节协会评分（KSS）进行功能评估，使用等速测力计以60°/秒的速度测量肌肉力量。分析了43例患者，他们接受了51次手术，其中铰链组包括25次手术，对照组包括26次初次手术。我们未观察到铰链组和对照组在功能KSS值（p = 0.54）、客观KSS值（p = 0.91）、屈肌峰值扭矩（p = 0.25）和伸肌峰值扭矩（p = 0.08）方面存在显著差异。接受初次关节置换术的铰链组患者的屈肌峰值扭矩（0.76 Nm/kg）高于因感染失败后翻修使用该植入物的患者（0.33 Nm/kg）（p < 0.05）。在严重韧带不稳定的关节置换翻修手术以及伴有骨破坏或冠状面严重冠状畸形的复杂初次关节置换病例中，建议使用限制性植入物。使用限制性植入物能够使关节功能和肌肉力量与使用传统后稳定型植入物进行初次关节置换术的患者相当。与接受初次限制性植入物关节置换术的患者相比，接受旋转铰链假体感染翻修术的患者屈肌力量较低。
