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初次全膝关节置换术中胫骨内翻基板下沉的致病因素:一项回顾性分析。

Causative factors for varus tibial baseplate subsidence in primary total knee arthroplasty: A retrospective analysis.

作者信息

Yixing Zhao Mars, Elaschuk Cole, Maqsood Aafia, Goldade Thomas, Girgis Samuel, Ashique Janan, Parchomchuk Evan, King Gavin, Beaulieu Mason, Nickol Michaela, van der Merwe Johannes M

机构信息

Department of Orthopaedic Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

出版信息

J Orthop. 2025 Jan 6;67:59-67. doi: 10.1016/j.jor.2024.12.023. eCollection 2025 Sep.

Abstract

BACKGROUND

In this retrospective study, the focus was on identifying potential causative factors associated with varus subsidence of the tibial component in primary total knee arthroplasty (TKA). The research aimed to investigate the risk factors contributing to aseptic varus tibial baseplate subsidence (VTBS) leading to revision TKA procedures.

PATIENTS AND METHODS

A total of 120 patients with documented VTBS complications post-TKA were compared with a control group of 52 patients. Factors such as patient demographics, surgical data and comorbidities were included. The study also explored the Coronal Plane Alignment of the Knee (CPAK) classification pre- and post-operatively to understand its implications on varus subsidence.

RESULTS

Significant differences noted in the VTBS group in variables including younger patient age (P=<0.001), increased BMI (P = 0.003), larger proportion of patients with tibial component oversize or undersizing (P=<0.001), less tibial stem extensions used (P < 0.001), higher CCI (P < 0.001) and a higher proportion of patients in CPAK group 2 (P = 0.044).

CONCLUSION

This investigation provides valuable insights into potential risk factors for VTBS, aiming to optimize patient outcomes and assist in preventing complications associated with TKA procedures.

摘要

背景

在这项回顾性研究中,重点是确定初次全膝关节置换术(TKA)中与胫骨组件内翻下沉相关的潜在致病因素。该研究旨在调查导致无菌性胫骨基板下沉(VTBS)并导致TKA翻修手术的危险因素。

患者与方法

共将120例TKA术后有记录的VTBS并发症患者与52例对照组患者进行比较。纳入了患者人口统计学、手术数据和合并症等因素。该研究还术前和术后探索了膝关节冠状面排列(CPAK)分类,以了解其对内翻下沉的影响。

结果

VTBS组在以下变量方面存在显著差异,包括患者年龄较轻(P<0.001)、BMI增加(P = 0.003)、胫骨组件尺寸过大或过小的患者比例更高(P<0.001)、使用的胫骨柄延伸较少(P < 0.001)、CCI较高(P < 0.001)以及CPAK第2组患者比例较高(P = 0.044)。

结论

本研究为VTBS的潜在危险因素提供了有价值的见解,旨在优化患者预后并协助预防与TKA手术相关的并发症。

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