全膝关节置换术中单部件翻修与双部件翻修的临床和功能结果比较。

L. Howard, C. Day, B. Masri, D. Garbuz
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摘要

目的:全膝关节置换术(TKA)的复查可能需要一个或两个胫骨和股骨假体。我们的目的是检查1组分TKA与2组分TKA修订的临床和功能结果。方法我们在单一中心鉴定了92例单组份(胫骨或股骨)翻修。我们的纳入标准是胫骨或股骨假体的单独翻修,随访至少2年。根据年龄、体重指数(BMI)、美国麻醉学会(ASA)评分和翻修指征,将纳入的病例与双组份翻修(胫骨和股骨)的对照组进行1:2匹配。我们收集了人口统计数据、并发症、手术时间、任何后续的再手术和功能结果评分。结果1组和2组的中位随访时间分别为10年(范围3 ~ 17年)和8年(范围2 ~ 18年)。两组再次翻修后最常见的并发症是僵硬,1组和2组分别为92例中9例(9.8%)和170例中9例(5.3%)(p=0.20)。1组分和2组分翻修组的总并发症发生率相似,分别为92例中有20例(22%)和170例中有35例(21%)(p=0.87)。在92个单成分组中有12个(13.0%)和170个双成分组中有18个(11%)出现了任何适应症的后续重新修订(p=0.69)。两组患者的生存率和功能结局评分无统计学差异。结论:我们的研究结果表明,单独翻修单个TKA组件是一种可接受的选择,与双组件翻修相比,其功能结局、并发症和生存率相当。因此,应在适当的地方考虑单组分修订。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Clinical and Functional Outcomes in One vs Two Component Revision for Total Knee Arthroplasty.
PURPOSE Revisions of total knee arthroplasties (TKA) may require revision of one or both tibial and femoral components. Our purpose was to examine the clinical and functional outcomes in 1- vs 2-component TKA revisions. METHODS We identified 92 1-component ( tibial or femoral) revisions at a single center. Our inclusion criteria were isolated revision of the tibial or femoral components with minimum 2-year follow-up. The included cases were matched 1:2 with a control group of 2-component revisions (tibial and femoral) by age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, and indication for revision. We collected demographics, complications, operative times, any subsequent re-revisions, and functional outcome scores. RESULTS The median follow-up time for the 1- and 2-component revision groups were 10 years (range, 3 to 17) and 8 years (range, 2 to 18), respectively. The most common complication after re-revision in both groups was stiffness at 9 of 92 (9.8%) and 9 of 170 (5.3%) in the 1- and 2-component groups, respectively (p=0.20). The overall complication prevalence in the 1- and 2- component revision groups was similar 20 of 92 (22%) and 35 of 170 (21%), respectively (p=0.87). Subsequent re-revisions for any indication were encountered in 12 of 92 (13.0%) of the 1-component and 18 of 170 (11%) in the 2-component groups (p=0.69). There was no statistical difference in survivorship or functional outcomes scores between the groups. CONCLUSIONS Our results sho wed that isolated revision of a single TKA component is an acceptable option, with comparable functional outcomes, complications, and survivorships when compared with both-component revision. As such, 1-component revision should be considered where appropriate.
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