Outcomes of Stemmed versus Un-Stemmed Varus-Valgus Constrained Components in Primary Total Knee Arthroplasty.

IF 1.7 Q2 ORTHOPEDICS

Orthopedic Research and Reviews Pub Date : 2021-01-07 eCollection Date: 2021-01-01 DOI:10.2147/ORR.S290015

Mina W Morcos, James L Howard, Brent Lanting, Steven MacDonald, Douglas Naudie, Richard McCalden, Edward M Vasarhelyi

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引用次数: 3

Abstract

Purpose: The necessity of stemmed components when performing a varus-valgus constrained (VVC) primary total knee arthroplasty (TKA) is unclear. The purpose of this study is to compare the outcomes of primary VVC TKA with and without stems at a minimum of two years.

Methods: Patients in our prospectively collected database with primary VVC TKAs were identified. Patient demographics, prosthesis data, time in vivo, characteristics of revision, and radiographs and PROMs were compared between the stemmed and un-stemmed cohorts.

Results: Sixty-five patients with 69 primary VVC TKAs were identified; 17 were implanted with stems and 52 without stems. Five of the stemmed TKAs (5/17) required revision at 15.1 years, while only one of the un-stemmed TKA (1/52) required a revision at 21.6 years (p=0.003) for aseptic loosening. Of the 5 stemmed TKAs requiring revision, 3 were for aseptic loosening and 2 were for PPJI. The un-stemmed cohort had a significantly higher final total KSS (p=0.048).

Conclusion: There was no increase in aseptic loosening or revision surgery in patients with non-stemmed primary VVC TKA compared to those with stemmed VVC TKA at mid-term follow-up. Utilizing non-stemmed TKA with VVC in appropriate cases is safe and may reduce cost, shorten operative time, and preserve bone-stock.

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原发性全膝关节置换术中有柄与无柄内翻受限部件的结果。

目的:在进行限制内翻(VVC)原发性全膝关节置换术(TKA)时，主干组件的必要性尚不清楚。本研究的目的是比较原发性VVC TKA在至少两年的时间里有和没有茎干的结果。方法:在我们前瞻性收集的数据库中对原发性VVC tka患者进行鉴定。患者人口统计学、假体数据、在体时间、翻修特征、x线片和PROMs在有茎和无茎队列之间进行比较。结果:确诊原发性VVC tka 65例，69例;有茎17例，无茎52例。5个有柄TKA(5/17)在15.1岁时需要翻修，而只有1个无柄TKA(1/52)在21.6岁时需要翻修(p=0.003)。在5个需要修改的tka中，3个是无菌性松动，2个是PPJI。无梗队列的最终总KSS显著高于对照组(p=0.048)。结论:在中期随访中，与有茎的VVC TKA患者相比，无茎的原发性VVC TKA患者的无菌松动或翻修手术没有增加。在适当的情况下使用无梗TKA和VVC是安全的，可以降低成本，缩短手术时间，保存骨储备。

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

Orthopedic Research and Reviews Medicine-Orthopedics and Sports Medicine

CiteScore

2.80

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Orthopedic Research and Reviews is an international, peer-reviewed, open-access journal focusing on the patho-physiology of the musculoskeletal system, trauma, surgery and other corrective interventions to restore mobility and function. Advances in new technologies, materials, techniques and pharmacological agents will be particularly welcome. Specific topics covered in the journal include: Patho-physiology and bioengineering, Technologies and materials science, Surgical techniques, including robotics, Trauma management and care, Treatment including pharmacological and non-pharmacological, Rehabilitation and Multidisciplinarian care approaches, Patient quality of life, satisfaction and preference, Health economic evaluations. The journal welcomes submitted papers covering original research, basic science and technology, clinical studies, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.