Khoo K M S, Lee W C, Foong C M B, Kunnasegaran R
Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore.
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Musculoskelet Surg. 2024 Nov 22. doi: 10.1007/s12306-024-00875-5.
Medial congruent (MC) systems and Posterior stabilized (PS) systems are widely utilized as implant options in total knee arthroplasties (TKAs). Nevertheless, determining which system yields superior clinical outcomes remains unresolved. This study seeks to compare these two systems by conducting a retrospective analysis of data from a single surgeon's registry encompassing both systems. Evaluation parameters consist of range of motion (ROM) and various clinical scoring systems.
A retrospective analysis of data from a single surgeon's registry compared 45 MC with PCL resected (MC-PCLR) TKAs with 44 PS TKAs. Inclusion criteria comprised primary knee osteoarthritis with a minimum 1-year follow-up, while exclusion criteria involved secondary knee osteoarthritis and revision TKAs. Range of motion, Oxford Knee Score (OKS), Knee Society Scoring System (KS) Function Score (KS-FS), and KS Knee Score (KS-KS) were assessed preoperatively, at 3 months, and at 12 months postoperatively. Statistical analysis was performed on retrieved data.
Both group has similar baseline demographics in terms of gender (68% vs. 73% female, p = 0.60), BMI (26.4 ± 5.7 vs. 28.3 ± 5.1 p = 0.81) and American Society for Anaesthesiology score (75% vs. 84% score of 2, p = 0.12), with the exception of age where the PS group is significantly greater (71 ± 8 vs. 66 ± 7 years, p < 0.01). There was no significant difference in range of motion (ROM), Oxford Knee Score (OKS), Knee Society Scoring System (KS) Function Score (KS-FS) and KS Knee Score (KS-KS) for all time periods except for one time stamp where preoperatively, the preoperative KS Knee Score (KS-KS) was significantly lower in the PS group. However, when comparing the change between KS-KS of pre-operation and 3 months post operation (44 ± 18 vs. 31 ± 18,p < 0.01), and pre-operation and 1 year post operation (46 ± 16 vs. 34 ± 17,p < 0.01), it is found to be significantly higher in the PS group for both time periods. All other comparisons between the three time periods were found to have similar parameters.
PS and MC-PCLR demonstrates similar outcomes at the 1-year mark. However PS exhibits a faster rate of improvement from pre-operation to 3 months as compared to MC-PCLR.
内侧稳定（MC）系统和后稳定（PS）系统在全膝关节置换术（TKA）中被广泛用作植入选项。然而，确定哪种系统能产生更好的临床效果仍未解决。本研究旨在通过对一位外科医生登记的包含这两种系统的数据进行回顾性分析，来比较这两种系统。评估参数包括活动范围（ROM）和各种临床评分系统。
对一位外科医生登记的数据进行回顾性分析，比较了45例切除后交叉韧带的内侧稳定（MC-PCLR）型TKA与44例PS型TKA。纳入标准包括原发性膝关节骨关节炎且至少随访1年，排除标准包括继发性膝关节骨关节炎和翻修TKA。在术前、术后3个月和术后12个月评估活动范围、牛津膝关节评分（OKS）、膝关节协会评分系统（KS）功能评分（KS-FS）和KS膝关节评分（KS-KS）。对检索到的数据进行统计分析。
两组在性别（女性分别为68%和73%，p = 0.60）、体重指数（26.4±5.7与28.3±5.1，p = 0.81）和美国麻醉医师协会评分（评分2分的分别为75%和84%，p = 0.12）方面具有相似的基线人口统计学特征，但年龄除外，PS组年龄显著更大（71±8岁与66±7岁，p < ）。除了一个时间点外，所有时间段的活动范围（ROM）、牛津膝关节评分（OKS）、膝关节协会评分系统（KS）功能评分（KS-FS）和KS膝关节评分（KS-KS）均无显著差异，在该时间点，术前PS组的术前KS膝关节评分（KS-KS）显著更低。然而，当比较术前与术后3个月（44±18与31±18，p < ）以及术前与术后1年（46±16与34±17，p < ）KS-KS的变化时，发现PS组在这两个时间段均显著更高。三个时间段之间的所有其他比较均发现参数相似。
PS和MC-PCLR在1年时显示出相似的结果。然而，与MC-PCLR相比，PS从术前到3个月的改善速度更快。
