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年轻患者队列中免水泥三组件全膝关节置换术的短期存活率。

Short-term survival of the cementless triathlon total knee arthroplasty in a young patient cohort.

机构信息

Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.

出版信息

Arch Orthop Trauma Surg. 2024 Sep;144(9):4109-4114. doi: 10.1007/s00402-024-05481-5. Epub 2024 Sep 9.

Abstract

BACKGROUND

The purpose of this study is to assess the short-term survivorship of a new cementless total knee arthroplasty (TKA) design in comparison to its cemented predecessor design in a young patient cohort less than 65 years of age.

METHODS

We performed a retrospective cohort study of all primary TKAs (cemented and cementless) in patients under the age of 65 at the time of the index procedure, in a single institution between May 2018 and May 2019. Primary outcome variables included aseptic revision and all-cause revision. Operative time was a secondary variable. Independent variables considered included age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) grade, implant type (cruciate-retaining (CR) or posterior-stabilised (PS)) and the use of cemented or cementless implants.

RESULTS

There were 106 cemented TKAs and 152 cementless TKAs (Triathlon, Stryker Inc, Mahwah, NJ ) implanted. The minimum follow-up for all cases was 2 years (mean cementless 32.5 months, mean cemented 34.9 months). Of the entire 258 implants only 2 were revised. Both revisions occurred in the cemented cohort for prosthetic joint infection (PJI). The all-cause revision rate in the cementless cohort was 0% compared to 1.8% in the cemented cohort (p = 0.168). Operative times were significantly reduced from 62 min in the cemented cohort to 52.2 min in the cementless cohort (p < 0.001).

CONCLUSION

In a young patient cohort, the cementless Triathlon TKA demonstrates excellent survivorship at short-term follow-up with significant reductions in operative times when compared to the cemented Triathlon TKA.

摘要

背景

本研究旨在评估一种新型非骨水泥全膝关节置换术(TKA)在 65 岁以下年轻患者中的短期生存率,并与骨水泥固定的前一代设计进行比较。

方法

我们对 2018 年 5 月至 2019 年 5 月在一家机构中接受初次 TKA(骨水泥固定和非骨水泥固定)的所有年龄小于 65 岁的患者进行了回顾性队列研究。主要结果变量包括无菌性翻修和全因翻修。手术时间是次要变量。考虑的独立变量包括年龄、性别、体重指数(BMI)、美国麻醉医师协会(ASA)分级、植入物类型(交叉韧带保留型(CR)或后稳定型(PS))以及骨水泥固定或非骨水泥固定植入物的使用。

结果

共植入 106 例骨水泥固定 TKA 和 152 例非骨水泥固定 TKA(Stryker Inc,新泽西州 Mahwah 的 Triathlon)。所有病例的最低随访时间均为 2 年(非骨水泥固定组平均 32.5 个月,骨水泥固定组平均 34.9 个月)。在 258 个植入物中只有 2 个被翻修。两次翻修均发生在骨水泥固定组,为假体关节感染(PJI)。非骨水泥固定组的全因翻修率为 0%,而骨水泥固定组为 1.8%(p=0.168)。非骨水泥固定组的手术时间从骨水泥固定组的 62 分钟显著减少至 52.2 分钟(p<0.001)。

结论

在年轻患者队列中,非骨水泥固定的 Triathlon TKA 在短期随访中表现出极好的生存率,与骨水泥固定的 Triathlon TKA 相比,手术时间显著减少。

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