Dalby Drew, Robison Alyssa M, Forrest Anthony, Bennett Steven, Patel Ashni, Cholewa Jason, Rolston Lindsey
University of Illinois College of Medicine, 1 Illini Dr, Peoria, IL, USA.
Henry Community Health, 2200 Forest Ridge Parkway, New Castle, IN47362, USA.
Arch Orthop Trauma Surg. 2024 Dec 23;145(1):90. doi: 10.1007/s00402-024-05729-0.
Indications for primary total knee arthroplasty (TKA) have become more inclusive of morbidly obese patients, however, higher rates of complications and lower implant survival have also been reported in this population. The purpose of this study was to investigate the mid-term survival, clinical, and radiographic outcomes of a cementless trabecular metal monoblock tibial component in severely obese patients.
This was a retrospective study of class II and III obese (BMI > 35) patients who received a cementless primary TKA. Standing radiographs were assessed for the presence of progressive tibial radiolucent lines (RLL), and clinical measures were assessed at least 2 years post-operative via the Oxford Knee Score (OKS), UCLA Activity and Satisfaction Score, and the Euro-QoL 5-dimension (EQ-5D-5L) index and visual analogue scale (EQ-VAS) health status.
Patients (n = 176) were 61.2 ± 8.3 years of age, BMI 44.9 ± 6.5 kg/m, and were predominantly female (n = 118, 66.7%). Mean follow-up was 59.2 ± 17.1 months. There were two total revisions at 6- and 57-months post-operative, respectively, and the 5-year survival estimate was 98.3% (95% confidence interval: 93.0%, 99.6%). Patient satisfaction was 93.9% and the post-operative OKS, EQ-5D-5L index, and EQ-VAS were 40.2 ± 7.9, 0.856 ± 0.205, and 73.6 ± 14.7, respectively. No cases of radiolucent lines were detected.
At 6 years this cementless monoblock tibial component demonstrated excellent survival without radiographic indications of aseptic loosening in a population of severely obese patients.
原发性全膝关节置换术（TKA）的适应证已更广泛地涵盖病态肥胖患者，然而，该人群中并发症发生率较高且植入物生存率较低的情况也有报道。本研究的目的是调查严重肥胖患者中无水泥小梁金属整体胫骨组件的中期生存率、临床和影像学结果。
这是一项对接受无水泥初次TKA的II级和III级肥胖（BMI＞35）患者的回顾性研究。评估站立位X线片上是否存在进行性胫骨透光线（RLL），并在术后至少2年通过牛津膝关节评分（OKS）、加州大学洛杉矶分校活动与满意度评分、欧洲五维健康量表（EQ-5D-5L）指数和视觉模拟量表（EQ-VAS）健康状况评估临床指标。
患者（n = 176）年龄为61.2±8.3岁，BMI为44.9±6.5kg/m²，且以女性为主（n = 118，66.7%）。平均随访时间为59.2±17.1个月。分别在术后6个月和57个月进行了两次全翻修手术，5年生存率估计为98.3%（95%置信区间：93.0%，99.6%）。患者满意度为93.9%，术后OKS、EQ-5D-5L指数和EQ-VAS分别为40.2±7.9、0.856±0.205和73.6±14.7。未检测到透光线病例。
在6年时，这种无水泥整体胫骨组件在严重肥胖患者群体中显示出优异的生存率，且无无菌性松动的影像学迹象。
