Outcomes of Medial Pivot Total Knee Arthroplasty (MP-TKA) Based on Preoperative Coronal Deformity.

IF 3.4 2区 医学 Q1 ORTHOPEDICS
Zachary Parisi, Jeffrey B Stambough, Eric R Siegel, Simon C Mears, C Lowry Barnes, Benjamin M Stronach
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引用次数: 0

Abstract

Introduction: The medial pivot total knee arthroplasty (MP-TKA) was developed to better replicate the kinematics of the healthy knee. Although outcomes of MP-TKA have been investigated, previous studies involved primarily varus preoperative deformities. The objective of this study was to determine patient outcomes using the Knee Injury and Osteoarthritis Outcome Score Jr (KOOS Jr) following MP-TKA in relation to the type (varus/neutral/valgus) and severity (moderate/severe) of preoperative coronal deformity.

Methods: This was a single-center retrospective cohort study of 311 knees receiving MP-TKA between April 25, 2017, and May 27, 2022, with a pre-operative long-leg hip-knee-ankle (HKA) angle measured by biplanar EOS. Patients were assigned to one of five varus/valgus alignment groups: neutral (0 ± 3 degrees), moderate (3 to 15 degrees), or severe (15+ degrees) pre-operative coronal deformity.

Results: Differences in sex were noted, while all other demographic and comorbid conditions were similar. The mean post-operative period between the date of surgery and KOOS Jr. collection was 17.6 months across all groups. Severe valgus knees (n = 5) had an average (mean ± SD) postoperative KOOS Jr of 71.7 ± 10.6, while moderate valgus knees (n = 49) demonstrated a postoperative average KOOS Jr. of 72.5 ± 19.6. Neutral knees (n = 53) had an average postoperative KOOS Jr of 65.2 ± 22.3, while moderate varus (n = 180) and severe varus (n = 24) had an average KOOS Jr of 69.9 ±19.1 and 73.2 ± 16.1, respectively. There was no difference noted in postoperative scores between the five deformity groups.

Discussion: The utilization of MP-TKA in patients who have moderate and severe valgus deformity showed similarly favorable outcomes when compared to neutral as well as moderate and severe varus knees. Further studies are needed to determine long-term outcomes with widespread MP-TKA use for all preoperative coronal deformities.

基于术前冠状畸形的内侧枢轴全膝关节置换术(MP-TKA)的疗效。
内侧枢轴全膝关节置换术(MP-TKA)是为了更好地复制健康膝关节的运动学而开发的。虽然MP-TKA的结果已经被调查过,但以前的研究主要涉及术前内翻畸形。本研究的目的是通过MP-TKA后的膝关节损伤和骨关节炎结局评分Jr (oos Jr)来确定患者的预后与术前冠状畸形的类型(内翻/中性/外翻)和严重程度(中度/重度)的关系。方法:这是一项单中心回顾性队列研究,研究对象为2017年4月25日至2022年5月27日期间接受MP-TKA的311个膝关节,术前采用双平面EOS测量长腿髋关节-膝关节-踝关节(HKA)角度。患者被分配到五个内翻/外翻对准组中的一个:中性(0±3度),中度(3至15度)或严重(15+度)术前冠状畸形。结果:注意到性别差异,而所有其他人口统计学和合并症情况相似。从手术日期到收集kos Jr.的平均术后时间为17.6个月。重度膝外翻(n = 5)术后平均(mean±SD) kos Jr为71.7±10.6,中度膝外翻(n = 49)术后平均kos Jr为72.5±19.6。中性膝(n = 53)术后平均KOOS Jr为65.2±22.3,中度内翻(n = 180)和重度内翻(n = 24)术后平均KOOS Jr分别为69.9±19.1和73.2±16.1。五组畸形术后评分无差异。讨论:MP-TKA在中度和重度膝内翻畸形患者中的应用与中性以及中度和重度膝内翻患者的效果相似。需要进一步的研究来确定广泛使用MP-TKA治疗所有术前冠状畸形的长期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Arthroplasty
Journal of Arthroplasty 医学-整形外科
CiteScore
7.00
自引率
20.00%
发文量
734
审稿时长
48 days
期刊介绍: The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
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