股骨假体屈曲对初次全膝关节置换术后预后的影响

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-05-22 DOI:10.1016/j.artd.2025.101718

Praharsha Mulpur MBBS, DNB (Ortho), Tarun Jayakumar MBBS, MS (Ortho), Mudidana Prudhvi MBBS, MS (Ortho), Krishna Raj Khanal MBBS, MS (Ortho), Kushal Hippalgaonkar MBBS, DNB (Ortho), A.V. Gurava Reddy MBBS, D.Ortho, DNB (Ortho), FRCS, MCh (Ortho)

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引用次数: 0

摘要

背景：全膝关节置换术（TKA）可改善终末期关节炎的疼痛缓解和功能。虽然冠状位对齐已经得到了很好的研究，但矢状面股骨假体屈曲对结果的影响仍未得到充分探讨。本研究使用Kujala膝关节前痛量表和机器人辅助TKA后的整体功能结果，研究股骨假体屈曲对髌股预后的影响。方法回顾性分析2022年1月至2023年1月间285例接受机器人辅助TKA的患者。股骨假体屈曲分为低（0°-2.5°）、中（2.6°-5.5°）和高（5.6°-8°）。采用Kujala评分、牛津膝关节评分（OKS）和膝关节社会评分（KSS）对术前和术后12个月的预后进行评估。统计分析包括比较组的方差分析和回归分析来评估屈曲对结果的影响。结果低屈曲组57例，中屈曲组108例，高屈曲组120例。低屈曲组的Kujala评分（73.89±12.68）明显高于中屈曲组（63.08±7.07）和高屈曲组（63.12±6.86），P <；。)。股骨屈曲每增加一个度，导致Kujala评分降低1.34分(P <；。)。术后各屈曲组的OKS和KSS均有明显改善，屈曲组间差异无统计学意义。患者满意度在两组间具有可比性，无显著差异。基于Kujala评分，股骨假体屈曲增加与髌骨预后较差相关。然而，通过OKS和KSS测量的总体患者报告的功能结果并未显示与股骨假体屈曲相关。

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Influence of Femoral Component Flexion on Outcomes After Primary Total Knee Arthroplasty

Background

Total knee arthroplasty (TKA) improves pain relief and function in end-stage arthritis. While coronal alignment has been well studied, the impact of femoral component flexion in the sagittal plane on outcomes remains underexplored. This study examines the effect of femoral component flexion on patellofemoral outcomes, using the Kujala anterior knee pain scale, and overall functional results after robotic-assisted TKA.

Methods

A retrospective review was conducted on 285 patients who underwent primary robotic-assisted TKA between January 2022 and January 2023. Femoral component flexion was classified as low (0°-2.5°), medium (2.6°-5.5°), and high (5.6°-8°). Outcomes were assessed preoperatively and 12 months postoperatively using the Kujala score, Oxford Knee Score (OKS), and Knee Society Score (KSS). Statistical analysis included analysis of variance for comparing groups and regression analysis to evaluate the impact of flexion on outcomes.

Results

A total of 57, 108, and 120 patients were categorized into low, medium, and high flexion groups, respectively. Kujala scores were significantly higher in the low flexion group (73.89 ± 12.68) compared to medium (63.08 ± 7.07) and high groups (63.12 ± 6.86, P < .0001). Each additional degree of femoral flexion resulted in a 1.34-point decrease in Kujala score (P < .0001). Postoperatively, the OKS and KSS improved significantly in all groups, with no statistically significant difference across flexion groups. Patient satisfaction was comparable across groups, with no significant difference.

Conclusions

Increased femoral component flexion was associated with poorer patellofemoral outcomes based on the Kujala score. However, the overall patient-reported functional outcome, as measured by the OKS and KSS, did not show a correlation with the flexion of the femoral component.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.