单块与模块化设计在非骨水泥全膝关节置换术中的长期迁移:一项使用放射立体分析的随机试验的二次报告。

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Mikkel Rathsach Andersen, Müjgan Yilmaz, Nikolaj Winther, Thomas Lind, Henrik Schrøder, Gunnar Flivik Flivik, Michael Mørk Petersen
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引用次数: 0

摘要

背景和目的:据报道,全膝关节置换术(TKA)中聚乙烯假体的后部磨损会产生临床显著水平的聚乙烯碎片,这可能导致无菌性松动和骨溶解。单块设计消除了聚乙烯的后部磨损,因此可以改善长期固定。这项随机临床试验(RCT)使用放射立体分析(RSA)比较了单块和模块化聚乙烯插入物的微运动,随访7年。方法:65例患者(平均年龄61岁)随机接受单块(n = 32)或模块(n = 33)非骨水泥金属胫骨小梁假体。35例患者(单块组18例,模块组17例)完成了7年的随访。研究的主要终点是最大总点运动(MTPM)。据报道,种植体的平移和旋转是次要终点。结果:84个月后,模块化组的平均MTPM为1.17(95%可信区间[CI] 0.90-1.41) mm,高于单一组的0.78 (CI 0.55-0.88) mm (P = 0.02),具有统计学意义。然而,连续迁移(12-84个月)没有差异,单块组为0.13 mm,模块化组为0.16 mm。结论:与模块化组相比,单块组的早期迁移明显降低,但12个月后的持续迁移没有差异,这证实了先前出版物的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis.

Background and purpose:  Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years' follow-up.

Methods:  65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years' follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.

Results:  After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90-1.41) mm compared with the monoblock group of 0.78 (CI 0.55-0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12-84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.

Conclusion:  There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.

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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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