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采用后稳定型 U2 膝关节系统进行全膝关节置换术的功能和影像学结果:5 年随访的 560 例回顾性研究。

Functional and radiological outcomes of total knee arthroplasty using posterior-stabilized U2 knee system: A retrospective study in 560 cases at five years of follow-up.

机构信息

Department of Orthopaedic and Traumatology, British Hospital of Buenos Aires, Perdriel 74, C1280 AEB, Buenos Aires, Argentina.

出版信息

Eur J Orthop Surg Traumatol. 2024 Dec;34(8):3939-3945. doi: 10.1007/s00590-024-04082-7. Epub 2024 Aug 31.

Abstract

PURPOSE

The purpose of this study was to assess clinical and functional outcomes as well as the prosthesis survival rates of the U2 Knee system in primary total knee arthroplasty (TKA) with a minimum follow-up of four years.

METHODS

We retrospectively analyzed 560 consecutively primary TKA performed between 2015 and 2019 due to osteoarthritis with a mean follow-up of 5.4 ± 1.1 years. The clinical outcomes were assessed using the knee society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic outcomes were assessed using the American knee society's roentgenographic evaluation system. Prosthetic survival was calculated using the Kaplan-Meier method.

RESULTS

Postoperative KSS showed significant improvement at one year (Clinical: 37.4 ± 4.1 vs. 91.9 ± 3.7; p < 0.01; Functional: 41.2 ± 3.3 vs. 90.6 ± 4.8; p =  < 0.01), with these improvements maintained throughout the follow-up period. The WOMAC score improved from 60 ± 10.1 preoperatively to 10.9 ± 8.3 (p = 0.02) at the end of the follow-up. There were 20 (3.7%) knees with radiolucent lines around the implant (< 2 mm), and none showed evidence of loosening. There were six (1.1%) revisions-four due to prosthetic joint infections and two due to periprosthetic femur fracture. The prosthetic survival was 97.8% at the study closure.

CONCLUSION

The U2 knee system demonstrates effective and safe performance for primary TKA with significant improvements in functional scores, patient-reported outcomes, and a promising prosthesis survival rate at mid-term follow-up. We will continue with the series analysis to assess the long-term outcomes.

摘要

目的

本研究旨在评估 U2 膝关节系统在初次全膝关节置换术(TKA)中的临床和功能结果以及假体生存率,随访时间至少为 4 年。

方法

我们回顾性分析了 2015 年至 2019 年间因骨关节炎行连续初次 TKA 的 560 例患者,平均随访 5.4±1.1 年。使用膝关节协会评分(KSS)和西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)评估临床结果。使用美国膝关节协会的 X 线评估系统评估 X 线结果。使用 Kaplan-Meier 方法计算假体生存率。

结果

术后 KSS 在 1 年时显示出显著改善(临床:37.4±4.1 对 91.9±3.7;p<0.01;功能:41.2±3.3 对 90.6±4.8;p<0.01),并且在整个随访期间保持了这些改善。WOMAC 评分从术前的 60±10.1 改善到随访结束时的 10.9±8.3(p=0.02)。有 20 个(3.7%)膝关节周围有植入物的透亮线(<2mm),但均无松动的证据。有 6 例(1.1%)进行了翻修,其中 4 例是由于假体关节感染,2 例是由于假体股骨骨折。研究截止时,假体生存率为 97.8%。

结论

U2 膝关节系统在初次 TKA 中表现出有效且安全的性能,在中期随访中功能评分、患者报告的结果和假体生存率均有显著改善。我们将继续进行系列分析以评估长期结果。

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