{"title":"采用内侧枢轴设计的低约束内衬是十字韧带固定全膝关节置换术良好疗效的潜在预测因素:倾向评分匹配分析","authors":"Yoshinori Okamoto, Takafumi Saika, Tomohiro Okayoshi, Takashi Ishitani, Hitoshi Wakama, Shuhei Otsuki","doi":"10.1002/ksa.12534","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The influence of polyethylene insert conformity on the outcomes of cruciate-retaining (CR) total knee arthroplasty (TKA) with a medial pivot design remains uncertain. Therefore, this study aimed to evaluate the effects of polyethylene insert conformity in CR-TKA on patient-reported outcomes.</p><p><strong>Methods: </strong>The data of 255 knees (FINE Total Knee System) from 255 patients were retrospectively analysed to compare outcomes for high- or low-constraint medial pivot inserts, as determined through historical controls, over an average follow-up period of 2.2 years (range, 2.0-5.5 years). Multivariate logistic regression analysis was used to identify predictors of achieving the patient-acceptable symptom state (PASS) for the Forgotten Joint Score-12 (FJS-12). Propensity score-matched cohorts for age, sex, body mass index, Kellgren-Lawrence grade, Charlson Comorbidity Index, knee flexion contracture, FJS-12 and follow-up duration were created for between-group comparison (n = 50 in each group).</p><p><strong>Results: </strong>Low-constraint insert (p = 0.031) and age (p = 0.043) were independent predictors of achieving the PASS for the FJS-12 (>33, 153/255). After successful matching, compared to the high-constraint insert, the low-constraint insert improved patient satisfaction (p = 0.029 for pain on going up or downstairs, and p = 0.047 for the function of going upstairs) and increased the likelihood of achieving the minimal clinically important difference (p = 0.019) and PASS (p = 0.025) for the FJS-12. A significant correlation was observed between the posterior tibial slope and the FJS-12 in the low-constraint insert group (p < 0.001), indicating that a greater posterior tibial slope was associated with better functional outcomes in this group.</p><p><strong>Conclusions: </strong>Compared with high-constraint inserts, low-constraint medial pivot inserts yielded higher functional outcomes and patient satisfaction. Therefore, insert conformity may play a crucial role in CR-TKA outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Low-constraint insert with a medial pivot design as a potential predictor of favourable outcomes in cruciate-retaining total knee arthroplasty: A propensity score-matched analysis.\",\"authors\":\"Yoshinori Okamoto, Takafumi Saika, Tomohiro Okayoshi, Takashi Ishitani, Hitoshi Wakama, Shuhei Otsuki\",\"doi\":\"10.1002/ksa.12534\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The influence of polyethylene insert conformity on the outcomes of cruciate-retaining (CR) total knee arthroplasty (TKA) with a medial pivot design remains uncertain. Therefore, this study aimed to evaluate the effects of polyethylene insert conformity in CR-TKA on patient-reported outcomes.</p><p><strong>Methods: </strong>The data of 255 knees (FINE Total Knee System) from 255 patients were retrospectively analysed to compare outcomes for high- or low-constraint medial pivot inserts, as determined through historical controls, over an average follow-up period of 2.2 years (range, 2.0-5.5 years). Multivariate logistic regression analysis was used to identify predictors of achieving the patient-acceptable symptom state (PASS) for the Forgotten Joint Score-12 (FJS-12). Propensity score-matched cohorts for age, sex, body mass index, Kellgren-Lawrence grade, Charlson Comorbidity Index, knee flexion contracture, FJS-12 and follow-up duration were created for between-group comparison (n = 50 in each group).</p><p><strong>Results: </strong>Low-constraint insert (p = 0.031) and age (p = 0.043) were independent predictors of achieving the PASS for the FJS-12 (>33, 153/255). After successful matching, compared to the high-constraint insert, the low-constraint insert improved patient satisfaction (p = 0.029 for pain on going up or downstairs, and p = 0.047 for the function of going upstairs) and increased the likelihood of achieving the minimal clinically important difference (p = 0.019) and PASS (p = 0.025) for the FJS-12. A significant correlation was observed between the posterior tibial slope and the FJS-12 in the low-constraint insert group (p < 0.001), indicating that a greater posterior tibial slope was associated with better functional outcomes in this group.</p><p><strong>Conclusions: </strong>Compared with high-constraint inserts, low-constraint medial pivot inserts yielded higher functional outcomes and patient satisfaction. Therefore, insert conformity may play a crucial role in CR-TKA outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12534\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12534","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Low-constraint insert with a medial pivot design as a potential predictor of favourable outcomes in cruciate-retaining total knee arthroplasty: A propensity score-matched analysis.
Purpose: The influence of polyethylene insert conformity on the outcomes of cruciate-retaining (CR) total knee arthroplasty (TKA) with a medial pivot design remains uncertain. Therefore, this study aimed to evaluate the effects of polyethylene insert conformity in CR-TKA on patient-reported outcomes.
Methods: The data of 255 knees (FINE Total Knee System) from 255 patients were retrospectively analysed to compare outcomes for high- or low-constraint medial pivot inserts, as determined through historical controls, over an average follow-up period of 2.2 years (range, 2.0-5.5 years). Multivariate logistic regression analysis was used to identify predictors of achieving the patient-acceptable symptom state (PASS) for the Forgotten Joint Score-12 (FJS-12). Propensity score-matched cohorts for age, sex, body mass index, Kellgren-Lawrence grade, Charlson Comorbidity Index, knee flexion contracture, FJS-12 and follow-up duration were created for between-group comparison (n = 50 in each group).
Results: Low-constraint insert (p = 0.031) and age (p = 0.043) were independent predictors of achieving the PASS for the FJS-12 (>33, 153/255). After successful matching, compared to the high-constraint insert, the low-constraint insert improved patient satisfaction (p = 0.029 for pain on going up or downstairs, and p = 0.047 for the function of going upstairs) and increased the likelihood of achieving the minimal clinically important difference (p = 0.019) and PASS (p = 0.025) for the FJS-12. A significant correlation was observed between the posterior tibial slope and the FJS-12 in the low-constraint insert group (p < 0.001), indicating that a greater posterior tibial slope was associated with better functional outcomes in this group.
Conclusions: Compared with high-constraint inserts, low-constraint medial pivot inserts yielded higher functional outcomes and patient satisfaction. Therefore, insert conformity may play a crucial role in CR-TKA outcomes.