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骨水泥型Attune全膝关节置换术中透亮线的发生率——一项回顾性临床与影像学研究

The incidence of radiolucent lines in cemented attune total knee arthroplasty- a retrospective clinical and radiological study.

作者信息

Sorbi Reza, Walker Tilman, Nees Timo A, Renkawitz Tobias, Moradi Babak, Reiner Tobias

机构信息

Department of Orthopaedics and Trauma Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Heidelberg, Germany.

Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Arch Orthop Trauma Surg. 2025 Mar 20;145(1):201. doi: 10.1007/s00402-025-05824-w.

Abstract

INTRODUCTION

The Attune total knee arthroplasty (TKA) system was introduced with the goal to improve clinical outcome, patient satisfaction and implant survival. The aim of the present study was to investigate the clinical and radiological outcome of the cemented Attune knee and to assess the rate of radiolucent lines (RLL) at a median follow-up of 4 years.

MATERIALS AND METHODS

In this single-center cohort study, we retrospectively evaluated the clinical and radiological results of 165 consecutive patients following cemented TKA with the original design of the Attune knee at a minimum follow-up of two years. Postoperative radiographs were assessed for RLL and clinical outcome was measured using patient reported outcome scores.

RESULTS

A total of 115 patients (127 knees) were available for assessment at a mean follow-up of 47.8 ± 12.9 months. The overall incidence of femoral and tibial RLL was 24% and 26%, respectively. Of the original cohort, two patients had to be revised during the course of the study, resulting in a survival rate of 98.9% at two years with the endpoint "revision for any reason". Clinical outcome scores improved significantly up to the latest follow-up.

CONCLUSIONS

The findings of this study demonstrated good clinical results with significant improvement in pain and knee function and acceptable revision rates at a median follow-up of 4 years. However, a high incidence of periprosthetic RLL was seen in this cohort. No implant showed signs of component loosening, but patients with RLL should be monitored closely and future studies with longer follow-up durations are necessary to investigate the influence of these radiolucencies on the long-term performance of this knee system.

摘要

引言

Attune全膝关节置换术(TKA)系统的推出旨在改善临床疗效、患者满意度和植入物生存率。本研究的目的是调查骨水泥固定的Attune膝关节的临床和放射学结果,并评估在中位随访4年时的透亮线(RLL)发生率。

材料与方法

在这项单中心队列研究中,我们回顾性评估了165例连续接受骨水泥固定TKA且采用Attune膝关节原始设计的患者的临床和放射学结果,随访时间至少为两年。对术后X线片进行RLL评估,并使用患者报告的结局评分来衡量临床结果。

结果

在平均随访47.8±12.9个月时,共有115例患者(127个膝关节)可供评估。股骨和胫骨RLL的总体发生率分别为24%和26%。在最初的队列中,有2例患者在研究过程中需要进行翻修,以“因任何原因进行翻修”为终点,两年时的生存率为98.9%。直至最近一次随访,临床结局评分有显著改善。

结论

本研究结果显示,在中位随访4年时临床效果良好,疼痛和膝关节功能有显著改善,翻修率可接受。然而,该队列中假体周围RLL的发生率较高。没有植入物显示出部件松动的迹象,但有RLL的患者应密切监测,并需要进行更长随访时间的未来研究,以调查这些透亮线对该膝关节系统长期性能的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d66b/11926027/43754bdc64c6/402_2025_5824_Fig1_HTML.jpg

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