Long-term outcomes, satisfaction, and survival rates of a medial pivot knee design

IF 2 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-06-09 DOI:10.1016/j.knee.2025.05.020

Matteo Innocenti, Filippo Leggieri, Alessandro Civinini, Fernando Nahuel Martín Cocilova, Davide Stimolo, Roberto Civinini

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引用次数: 0

Abstract

Background

The aim of this study was to evaluate the long-term clinical outcomes, satisfaction, perceived joint stability, and survival rates following medial pivot TKA.

Methods

Data from TKAs performed at a single institution between 2008 and 2014 were retrospectively reviewed. Patients without consent were excluded. Inclusion: medial pivot TKA surgery. All patients received the same cemented Microport Advanced® and Evolution® Medial Pivot Knee System. Data collection comprised clinical and radiological outcomes, time of failure and/or death, surgical techniques (measured resection (MR) femur first technique following mechanical alignment principles vs. gap balancing (GB) tibia first technique preserving preoperative varus deformity up to 4°). Kaplan–Meier survival analysis compared survival between surgical techniques. Logistic regression evaluated surgical technique as a predictor for revision status. Risk analysis calculated relative and absolute risk differences between surgical techniques.

Results

Of the 137 patients included in the final analysis, there were 24 deaths (17.5%), 15 lost to follow up (10.9%), four revisions (2.9%). The final follow up was obtained for 94 patients (68.6%) without revision. The mean survival was 16.14 years (95% CI: 15.96–16.32; standard error = 0.93) at the final follow up with a median of 11.32 years (IQR, 9.57–14.04). The Kaplan–Meier/Mantel–Cox indicated no difference in survival between MR and GB (Chi-squared = 0.02, P = 0.876). No other predictors for revision were found (CPAK (P = 0.78), aHKA (P = 0.55), MPTA (P = 0.73)). Nine (6.6%) patients stated that they were not satisfied with no difference for surgical technique (Chi-squared = 0.59, P = 0.824).

Conclusions

The overall mean survival time was estimated to be 16.14 years with 97% survival rate.

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内侧枢轴膝关节设计的长期预后、满意度和生存率

本研究的目的是评估内侧支点TKA后的长期临床结果、满意度、感知关节稳定性和生存率。方法回顾性分析2008年至2014年在一家机构进行tka的数据。未经同意的患者被排除在外。纳入：内侧枢轴TKA手术。所有患者均接受了相同的骨水泥Microport Advanced®和Evolution®Medial Pivot Knee System。数据收集包括临床和放射学结果、失败和/或死亡时间、手术技术（遵循机械对准原则的测量切除（MR）股骨优先技术与间隙平衡（GB）胫骨优先技术，保留术前内翻畸形达4°）。Kaplan-Meier生存分析比较了两种手术方式的生存率。逻辑回归评估手术技术作为翻修状态的预测因子。风险分析计算手术技术之间的相对和绝对风险差异。结果最终分析的137例患者中，死亡24例（17.5%），失访15例（10.9%），复查4例（2.9%）。最终随访94例（68.6%），无修改。平均生存期为16.14年(95% CI: 15.96-16.32；标准误差= 0.93)，中位年龄为11.32岁（IQR, 9.57 ~ 14.04）。Kaplan-Meier / Mantel-Cox显示MR与GB的生存率无差异（χ 2 = 0.02, P = 0.876）。未发现其他预测因子（CPAK （P = 0.78）、aHKA （P = 0.55）、MPTA (P = 0.73)）。9例（6.6%）患者表示不满意，手术技术差异无统计学意义（χ 2 = 0.59, P = 0.824）。结论总平均生存期为16.14年，生存率为97%。

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

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.