一种新推出的全膝关节置换术设计的无骨水泥固定与有骨水泥固定的四年疗效对比。

IF 1.1 4区 医学 Q3 ORTHOPEDICS
Orthopedics Pub Date : 2024-05-01 Epub Date: 2024-01-25 DOI:10.3928/01477447-20240122-02
Timothy G Costales, David F Dalury
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引用次数: 0

摘要

背景:无菌性松动仍然是全膝关节置换术(TKA)失败的主要原因。尽管骨水泥固定仍是金标准,但无骨水泥固定作为通过生物固定降低这一风险的一种手段,再次引起了人们的兴趣。本研究的目的是评估一种新引进的 TKA 设计的有骨水泥和无骨水泥版本在术后平均 4 年的临床效果:这是一项回顾性病例对照研究,对 100 例使用相同十字韧带固定假体设计(ATTUNE 膝关节系统;DePuy Synthes)的初次 TKA 进行了无骨水泥与有骨水泥 TKA 的比较。接受无骨水泥 TKA 治疗的 50 名患者的平均年龄为 60.8 岁(范围为 48-71 岁),体重指数 (BMI) 为 31.6 kg/m2(范围为 23.7-41.9 kg/m2);接受初次骨水泥 TKA 治疗的 50 名患者的平均年龄为 62.7 岁(范围为 51-73 岁),体重指数 (BMI) 为 30.1 kg/m2(范围为 24.6-43.9 kg/m2)。无骨水泥组的平均随访时间为4.2年(范围为4.0-4.4年),有骨水泥组的平均随访时间为7.6年(范围为7.5-7.7年)。在最终随访时对并发症、膝关节社会评分(KSS)的临床结果和放射学分析进行了评估。统计分析采用学生 t 检验:两组患者的年龄、体重指数和术前 KSS 均无统计学差异(分别为 P=.12、P=.15 和 P=.55)。两组患者均未出现并发症或再次手术。两组患者在最终随访时的活动范围和总 KSS 均无统计学差异。无骨水泥组的最终总 KSS 平均值为 91.1,有骨水泥组为 93.7。两组患者均未出现组件下沉或松动的影像学证据:结论:新引进的无骨水泥 TKA 与有骨水泥 TKA 相比,在平均 4 年的随访中具有相似的出色临床改善和放射学结果。[骨科。202x;4x(x):xx-xx]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Four-Year Outcomes of Cementless Versus Cemented Fixation of a Newly Introduced Total Knee Arthroplasty Design.

Background: Aseptic loosening continues to be a major cause of failure of total knee arthroplasty (TKA). Although cemented fixation remains the gold standard, there is renewed interest in cementless fixation as a means of decreasing this risk via biologic fixation. The purpose of this study was to evaluate the clinical outcomes of cemented and cementless versions of a newly introduced TKA design at an average of 4 years postoperatively.

Materials and methods: This was a retrospective case-control study of 100 primary TKAs comparing cementless vs cemented TKAs using the same cruciate-retaining implant design (ATTUNE Knee System; DePuy Synthes). Fifty patients undergoing cementless TKA with a mean age of 60.8 years (range, 48-71 years) and body mass index (BMI) of 31.6 kg/m2 (range, 23.7-41.9 kg/m2) were matched to 50 patients undergoing primary cemented TKA with a mean age of 62.7 years (range, 51-73 years) and BMI of 30.1 kg/m2 (range, 24.6-43.9 kg/m2). The mean follow-up was 4.2 years (range, 4.0-4.4 years) in the cementless group and 7.6 years (range, 7.5-7.7 years) in the cemented group. Complications, clinical outcomes using the Knee Society Score (KSS), and radiographic analyses were evaluated at final follow-up. Student's t tests were used for statistical analyses.

Results: There was no statistical difference in age, BMI, and preoperative KSS between the two groups (P=.12, P=.15, and P=.55, respectively). There were no complications or reoperations in either cohort. There were no statistical differences in range of motion and total KSS at final follow-up between the two groups. Final total KSS had a mean of 91.1 for the cementless group and 93.7 for the cemented group. There was no radiographic evidence of component subsidence or loosening in either cohort.

Conclusion: When compared with its cemented counterpart, the newly introduced cementless TKA design had similar excellent clinical improvements and radiologic results at an average of 4 years of follow-up. [Orthopedics. 2024;47(3):161-166.].

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来源期刊
Orthopedics
Orthopedics 医学-整形外科
CiteScore
2.20
自引率
0.00%
发文量
160
审稿时长
3 months
期刊介绍: For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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