Anjiki Kensuke, Nakano Naoki, Ishida Kazunari, Takayama Koji, Fujita Masahiro, Kamenaga Tomoyuki, Tsubosaka Masanori, Kuroda Yuichi, Hayashi Shinya, Kuroda Ryosuke, Matsumoto Tomoyuki
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, 657-0068, Japan.
Arthroplasty. 2024 Jul 4;6(1):40. doi: 10.1186/s42836-024-00257-z.
Both kinematically-aligned (KA) total knee arthroplasty (TKA) and bicruciate stabilized (BCS) TKA aim to reproduce the physiological knee kinematics. In this study, we compared the femoro-tibial component rotational mismatch between patients who underwent modified KA-TKA and those who received guided-motion BCS-TKA, and its influence on the clinical outcomes.
In this retrospective study, 77 consecutive patients were included and divided into two groups: subjects who underwent modified KA-TKA with Persona (KA Group; n = 42) and those who received BCS-TKA with JOURNEY II (BCS group; n = 35). Range of motion, the 2011 Knee Society Score (KSS), the rotational alignment of the femoral and tibial components, and the correlations between the rotational mismatch and the 2011 KSS subscales were examined.
The postoperative objective knee indicators (P = 0.0157), patient satisfaction (P = 0.0039) and functional activity scores (P = 0.0013) in the KA group were significantly superior to those in the BCS group 1 year postoperatively. There was no significant difference between the two groups observed in the rotational mismatch. In the BCS group, significant negative correlations were identified between the rotational mismatch and objective indicators, patient satisfaction, and functional activity scores but not in the KA group.
The short-term clinical results following KA-TKA showed superior objective knee indicators, patient satisfaction and functional activity scores. A negative correlation was observed between component rotational mismatch and the 2011 KSS subscales in the BCS group, compared to no relationship found between the two in the KA group. These findings suggested that KA-TKA has a relatively higher tolerance for rotational mismatch than BCS-TKA.
运动学对齐(KA)全膝关节置换术(TKA)和双交叉韧带稳定(BCS)TKA均旨在重现膝关节的生理运动学。在本研究中,我们比较了接受改良KA-TKA的患者与接受引导运动BCS-TKA的患者之间的股骨-胫骨组件旋转不匹配情况及其对临床结果的影响。
在这项回顾性研究中,纳入了77例连续患者并将其分为两组:接受Persona改良KA-TKA的受试者(KA组;n = 42)和接受JOURNEY II BCS-TKA的受试者(BCS组;n = 35)。检查了活动范围、2011年膝关节协会评分(KSS)、股骨和胫骨组件的旋转对齐情况,以及旋转不匹配与2011年KSS子量表之间的相关性。
术后1年,KA组的术后客观膝关节指标(P = 0.0157)、患者满意度(P = 0.0039)和功能活动评分(P = 0.0013)均显著优于BCS组。两组在旋转不匹配方面未观察到显著差异。在BCS组中,旋转不匹配与客观指标、患者满意度和功能活动评分之间存在显著负相关,但在KA组中未发现这种相关性。
KA-TKA术后的短期临床结果显示出更好的客观膝关节指标、患者满意度和功能活动评分。与KA组中两者之间未发现关系相比,BCS组中组件旋转不匹配与2011年KSS子量表之间存在负相关。这些发现表明,KA-TKA对旋转不匹配的耐受性相对高于BCS-TKA。