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Similar Recovery Rate for Patients Aged between 50 and 89 Years That Go Home on the Surgery Day and Self-Administer Their Rehabilitation after Kinematically Aligned Total Knee Arthroplasty.在运动学对齐全膝关节置换术后于手术当天回家并自行进行康复训练的50至89岁患者的恢复率相似。
J Pers Med. 2024 May 10;14(5):504. doi: 10.3390/jpm14050504.
2
Ball-in-socket medial conformity with posterior cruciate ligament retention neither limits internal tibial rotation and knee flexion nor lowers clinical outcome scores after unrestricted kinematically aligned total knee arthroplasty.球窝型内侧骨面符合后交叉韧带保留,并不会限制膝关节在非限制型运动学对线全膝关节置换术后的胫骨内旋和屈膝活动度,也不会降低临床结果评分。
Int Orthop. 2023 Jul;47(7):1737-1746. doi: 10.1007/s00264-023-05834-6. Epub 2023 May 17.
3
Kinematic alignment versus mechanical alignment in total knee arthroplasty: An up-to-date meta-analysis.全膝关节置换术中的运动对线与机械对线:最新的荟萃分析。
J Orthop Surg (Hong Kong). 2022 Sep-Dec;30(3):10225536221125952. doi: 10.1177/10225536221125952.
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An insert with less than spherical medial conformity causes a loss of passive internal rotation after calipered kinematically aligned TKA.非球形内侧衬垫会导致卡尺对线 TKA 后被动内旋丧失。
Arch Orthop Trauma Surg. 2021 Dec;141(12):2287-2294. doi: 10.1007/s00402-021-04054-0. Epub 2021 Jul 15.
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A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention closely restores native knee tibial rotation after unrestricted kinematic alignment.一种具有球窝内侧贴合性和后交叉韧带保留功能的新型胫骨插入物设计,在无限制运动学对线后能密切恢复天然膝关节的胫骨旋转。
J Exp Orthop. 2023 Nov 15;10(1):115. doi: 10.1186/s40634-023-00671-3.
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The Trochlear Groove of a Femoral Component Designed for Kinematic Alignment Is Lateral to the Quadriceps Line of Force and Better Laterally Covers the Anterior Femoral Resection Than a Mechanical Alignment Design.为运动学对线设计的股骨假体的滑车沟位于股四头肌力线外侧,与机械对线设计相比,能更好地从外侧覆盖股骨前方截骨面。
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A Torn or Reconstructed Anterior Cruciate Ligament Does Not Adversely Affect Clinical Outcome Scores and the Incidence of Reoperation After Unrestricted Kinematically Aligned Total Knee Arthroplasty.重建或撕裂前交叉韧带不会对全膝关节置换术后的临床结果评分和非限制性运动学对线的再手术发生率产生不利影响。
J Arthroplasty. 2023 Dec;38(12):2612-2617. doi: 10.1016/j.arth.2023.06.018. Epub 2023 Jun 13.
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Posterior cruciate ligament retention with medial ball-in-socket conformity promotes internal tibial rotation and knee flexion while providing high clinical outcome scores.保留后交叉韧带并采用内侧球窝适配设计可促进胫骨内旋和膝关节屈曲,同时带来较高的临床疗效评分。
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Kinematic aligned femoral rotation leads to greater patella tilt but similar clinical outcomes when compared to traditional femoral component rotation in total knee arthroplasty. A propensity score matched study.在全膝关节置换术中,与传统股骨组件旋转相比,运动对线股骨旋转可导致更大的髌骨倾斜,但临床结果相似。一项倾向评分匹配研究。
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1059-1066. doi: 10.1007/s00167-020-06081-7. Epub 2020 Jun 1.
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Short-term follow-up of kinematically vs. mechanically aligned total knee arthroplasty with medial pivot components: A case-control study.膝关节运动学与机械对线的内侧铰链型全膝关节置换术的短期随访:病例对照研究。
Orthop Traumatol Surg Res. 2020 Sep;106(5):921-927. doi: 10.1016/j.otsr.2020.04.005. Epub 2020 Jun 7.

引用本文的文献

1
Early Outcome of Simultaneous Bilateral Total Knee Arthroplasty Through the Oxford Knee Score in a Developing Country: A Prospective Cohort.通过牛津膝关节评分评估发展中国家同期双侧全膝关节置换术的早期疗效:一项前瞻性队列研究
Cureus. 2024 Jul 28;16(7):e65563. doi: 10.7759/cureus.65563. eCollection 2024 Jul.

本文引用的文献

1
Kinematic Alignment Technique Outperforms Mechanical Alignment in Simultaneous Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial.在同期双侧全膝关节置换术中,运动学对线技术优于机械对线:一项随机对照试验
J Arthroplasty. 2024 Sep;39(9):2234-2240. doi: 10.1016/j.arth.2024.03.045. Epub 2024 Mar 25.
2
Age-Related Differences in Pain, Function, and Quality of Life Following Primary Total Knee Arthroplasty: Results From a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) Cohort.原发性全膝关节置换术后疼痛、功能和生活质量的年龄相关差异:FORCE-TJR(全关节置换术比较有效性的功能和结果研究)队列的结果。
J Arthroplasty. 2023 Jul;38(7 Suppl 2):S169-S176. doi: 10.1016/j.arth.2023.04.005. Epub 2023 Apr 29.
3
Caliper-Verified Kinematically Aligned Total Knee Arthroplasty: Rationale, Targets, Accuracy, Balancing, Implant Survival, and Outcomes.卡尺验证的运动学对线全膝关节置换术:原理、目标、准确性、平衡、假体生存率和结果。
Instr Course Lect. 2023;72:241-259.
4
The Trochlear Groove of a Femoral Component Designed for Kinematic Alignment Is Lateral to the Quadriceps Line of Force and Better Laterally Covers the Anterior Femoral Resection Than a Mechanical Alignment Design.为运动学对线设计的股骨假体的滑车沟位于股四头肌力线外侧,与机械对线设计相比,能更好地从外侧覆盖股骨前方截骨面。
J Pers Med. 2022 Oct 16;12(10):1724. doi: 10.3390/jpm12101724.
5
Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA.测量胫骨方向有助于选择最佳植入物厚度,以个体化内侧球窝型全膝关节置换术中后交叉韧带的张力。
J Pers Med. 2022 Aug 31;12(9):1427. doi: 10.3390/jpm12091427.
6
A TKA Insert with A Lateral Flat Articular Surface Maximizes External and Internal Tibial Orientations without Anterior Lift-Off Relative to Low- and Ultracongruent Surfaces.具有外侧扁平关节面的全膝关节置换插入物相对于低匹配度和超高匹配度表面,在不存在前侧抬离的情况下可使胫骨内外侧方位最大化。
J Pers Med. 2022 Aug 3;12(8):1274. doi: 10.3390/jpm12081274.
7
Same-Day Discharge Total Knee Arthroplasty in Octogenarians.八旬老人全膝关节置换术的当日出院
J Arthroplasty. 2023 Jan;38(1):96-100. doi: 10.1016/j.arth.2022.08.013. Epub 2022 Aug 17.
8
A Surgeon That Switched to Unrestricted Kinematic Alignment with Manual Instruments Has a Short Learning Curve and Comparable Resection Accuracy and Outcomes to Those of an Experienced Surgeon.一名改用手动器械进行无限制运动学对线的外科医生学习曲线较短,其切除精度和手术效果与经验丰富的外科医生相当。
J Pers Med. 2022 Jul 16;12(7):1152. doi: 10.3390/jpm12071152.
9
Negligible effect of surgeon experience on the accuracy and time to perform unrestricted caliper verified kinematically aligned TKA with manual instruments.在使用手动器械进行无限制卡尺验证的运动学对线全膝关节置换术中,外科医生经验对准确性和操作时间的影响可忽略不计。
Knee Surg Sports Traumatol Arthrosc. 2022 Sep;30(9):2966-2974. doi: 10.1007/s00167-022-06939-y. Epub 2022 Apr 2.
10
How well do elderly patients do after total knee arthroplasty in the era of fast-track surgery?在快速康复外科时代,老年患者全膝关节置换术后的恢复情况如何?
Arthroplasty. 2020 Jun 22;2(1):16. doi: 10.1186/s42836-020-00037-5.

在运动学对齐全膝关节置换术后于手术当天回家并自行进行康复训练的50至89岁患者的恢复率相似。

Similar Recovery Rate for Patients Aged between 50 and 89 Years That Go Home on the Surgery Day and Self-Administer Their Rehabilitation after Kinematically Aligned Total Knee Arthroplasty.

作者信息

Akhtar Muzammil, Howell Stephen M, Nedopil Alexander J, Hull Maury L

机构信息

College of Medicine, California Northstate University, Elk Grove, CA 95757, USA.

Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA.

出版信息

J Pers Med. 2024 May 10;14(5):504. doi: 10.3390/jpm14050504.

DOI:10.3390/jpm14050504
PMID:38793086
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11122277/
Abstract

BACKGROUND

for kinematic alignment (KA) total knee arthroplasty (TKA), it was unknown whether 'the pace of recovery' at six weeks was different for patients with ages ranging between 50-59, 60-69, 70-79, and 80-89 years who were discharged on the surgery day and self-administered their rehabilitation.

METHODS

a single surgeon treated 206 consecutive patients with a KA-designed femoral component and an insert with a medial ball-in-socket, lateral flat articulation, and PCL retention. Each filled out preoperative and six-week Oxford Knee Score (OKS), Knee Society Score (KSS), Knee Function Score (KFS), and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) questionnaires. The six-week minus preoperative value indicated improvement.

RESULTS

between age cohorts, the improvement was not different ( = 0.2319 to 0.9888). The mean improvement/six-week postoperative value was 6°/-2° for knee extension, 0°/119° for knee flexion, 7/31 for the OKS, 39/96 for the KSS, 7/64 for the KFS, and 13/62 for the KOOS. The 30-day hospital readmission rate was 1%.

CONCLUSION

surgeons who perform KA TKA can counsel 50 to 89-year-old patients that they can be safely discharged home on the surgery day with a low risk of readmission and can achieve better function at six weeks than preoperatively when performing exercises without a physical therapist.

摘要

背景

对于采用运动学对线(KA)的全膝关节置换术(TKA),手术当天出院并自行进行康复训练的50 - 59岁、60 - 69岁、70 - 79岁和80 - 89岁患者在六周时的“恢复速度”是否存在差异尚不清楚。

方法

一位外科医生连续治疗了206例患者,使用的是设计为KA的股骨组件以及带有内侧球窝、外侧平面关节和保留后交叉韧带(PCL)的衬垫。每位患者都填写了术前和六周时的牛津膝关节评分(OKS)、膝关节协会评分(KSS)、膝关节功能评分(KFS)以及膝关节置换的膝关节损伤和骨关节炎结局评分(KOOS,JR)问卷。六周评分减去术前评分的值表示改善情况。

结果

在不同年龄组之间,改善情况没有差异( = 0.2319至0.9888)。术后六周膝关节伸展的平均改善/值为6°/-2°,膝关节屈曲为0°/119°,OKS为7/31,KSS为39/96,KFS为7/64,KOOS为13/62。30天再入院率为1%。

结论

进行KA TKA手术的外科医生可以告知50至89岁的患者,他们在手术当天可以安全出院回家,再入院风险低,并且在六周时进行无物理治疗师指导的锻炼时,能比术前获得更好的功能。