Department of Orthopaedic Surgery, Chang Gung Memorial Hospital (CGMH), No. 5 Fu-Hsing Street, Kweishan, Taoyuan city, Taiwan.
Bone and Joint Research Center, Chang Gung Memorial Hospital (CGMH), No. 5 Fu-Hsing Street, Kweishan, Taoyuan city, Taiwan.
BMC Musculoskelet Disord. 2024 Oct 12;25(1):806. doi: 10.1186/s12891-024-07925-w.
In total knee arthroplasty (TKA), isolated aseptic loosening (IAL) requires the replacement of prosthetic components, with ongoing debate regarding the effectiveness of partial component revision (PCR) compared to total component revision (TCR). This study aims to compare implant survival and surgical outcomes between PCR and TCR in the context of IAL.
This retrospective study analyzed data from 285 patients who underwent revision TKA for IAL between January 2000 and December 2013. After applying exclusion criteria, 112 patients were included in the analysis-60 undergoing TCR and 52 undergoing PCR.
PCR was associated with shorter operative times and hospital stays compared to TCR, alongside significant differences in the choice of revision prostheses. Although the prosthesis failure rates were comparable between the groups (13.6% for TCR and 18.33% for PCR), significant risk factors for failure were identified, including a canal filling ratio (CFR) below 0.8 and a discrepancy over 0.2 between CFR views. However, no significant differences in overall survivorship were observed between the groups.
Both PCR and TCR provide similar survival rates and clinical outcomes for managing IAL in TKA. PCR provides advantages in terms of surgical efficiency and patient recovery, while reducing the need for more constrained prosthetic solutions. The study identifies CFR as a critical predictor of prosthesis failure, highlighting the importance of detailed preoperative planning and implant selection. These findings contribute valuable insights for improving revision strategies in IAL, enhancing surgical outcomes in TKA.
III.
在全膝关节置换术（TKA）中，单纯无菌性松动（IAL）需要更换假体部件，目前仍在争论与全部件翻修（TCR）相比，部分部件翻修（PCR）的有效性。本研究旨在比较 IAL 情况下 PCR 和 TCR 对假体存活率和手术结果的影响。
本回顾性研究分析了 2000 年 1 月至 2013 年 12 月期间因 IAL 行翻修 TKA 的 285 例患者的数据。应用排除标准后，112 例患者被纳入分析，其中 60 例接受 TCR，52 例接受 PCR。
PCR 与 TCR 相比，手术时间和住院时间更短，同时在翻修假体的选择上存在显著差异。尽管两组的假体失败率相当（TCR 为 13.6%，PCR 为 18.33%），但仍确定了一些失败的显著危险因素，包括管腔填充率（CFR）低于 0.8 和 CFR 视图之间的差异超过 0.2。然而，两组之间的总体生存率无显著差异。
PCR 和 TCR 在处理 TKA 中的 IAL 方面均提供了相似的存活率和临床结果。PCR 在手术效率和患者恢复方面具有优势，同时减少了对更受限的假体解决方案的需求。本研究确定 CFR 是假体失败的关键预测因素，强调了详细术前规划和植入物选择的重要性。这些发现为改进 IAL 中的翻修策略提供了有价值的见解，提高了 TKA 的手术结果。
III 级。
