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接受中立对线全膝关节置换术的患者术前外翻畸形的影响:一项最少随访 5 年的回顾性队列研究。

Effects of preoperative valgus deformity in patients undergoing neutrally aligned total knee arthroplasty: A retrospective cohort study with a minimum five-year follow-up.

机构信息

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, #37 Guoxue Road, Chengdu, 610041, People's Republic of China.

出版信息

Jt Dis Relat Surg. 2024 Aug 14;35(3):529-537. doi: 10.52312/jdrs.2024.1800.

Abstract

OBJECTIVES

This study aimed to investigate the relationship between the severity of preoperative valgus deformity and clinical outcomes of neutrally aligned total knee arthroplasty (TKA).

PATIENTS AND METHODS

A total of 376 knees with valgus deformity who underwent TKA from January 2006 to March 2014 were retrospectively screened, and 287 knees (242 patients; 32 males, 210 females; mean age: 64.5±8.8 years; range, 35 to 83 years) aligned neutrally after the operation were included. Patients were divided into four groups based on the preoperative hip-knee-ankle (HKA): mild (0°< HKA ≤5°, n=94), moderate (5°< HKA ≤10°, n=74), severe (10°< HKA ≤15°, n=75), and very severe (HKA >15°, n=44) groups. Range of motion (ROM), Knee Society Score (KSS), Visual Analog Scale (VAS) dynamic pain scores, and Forgotten Joint Score (FJS) were evaluated. Mechanical failures were recorded to assess prosthesis survival. A survival rate analysis was performed using Kaplan-Meier survival analysis.

RESULTS

The degree of preoperative valgus deformity did not have a significant impact on the postoperative ROM, KSS, VAS dynamic pain scores, or FJS at the last follow-up. There were no significant differences in cumulative survival rates of neutrally aligned TKAs at 10 years between the four groups (p=0.513).

CONCLUSION

The severity of preoperative valgus deformity did not affect the clinical outcomes of neutrally aligned TKAs in the minimum five-year follow-up. Additionally, it did not impact the survival rates of neutrally aligned TKAs over 10 years.

摘要

目的

本研究旨在探讨术前外翻畸形严重程度与中立位全膝关节置换术(TKA)临床结果之间的关系。

患者和方法

回顾性筛选了 2006 年 1 月至 2014 年 3 月期间因外翻畸形接受 TKA 的 376 膝,术后对线中立的 287 膝(242 例患者;32 名男性,210 名女性;平均年龄:64.5±8.8 岁;范围:35 岁至 83 岁)纳入研究。患者根据术前髋膝踝角(HKA)分为四组:轻度(0°<HKA≤5°,n=94)、中度(5°<HKA≤10°,n=74)、重度(10°<HKA≤15°,n=75)和极重度(HKA>15°,n=44)。评估了膝关节活动度(ROM)、膝关节学会评分(KSS)、视觉模拟量表(VAS)动态疼痛评分和遗忘关节评分(FJS)。记录机械故障以评估假体生存率。采用 Kaplan-Meier 生存分析进行生存率分析。

结果

术前外翻畸形程度对术后 ROM、KSS、VAS 动态疼痛评分或末次随访时的 FJS 无显著影响。四组 10 年中立位 TKA 的累积生存率无显著差异(p=0.513)。

结论

在至少 5 年的随访中,术前外翻畸形的严重程度不影响中立位 TKA 的临床结果。此外,它对 10 年以上中立位 TKA 的生存率没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e9a/11411898/46c567951fe7/JDRS-2024-35-3-529-537-F1.jpg

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