Abstract：
OBJECTIVE: Modular cementless knee arthroplasty systems are capable of precise reconstruction of the mechanical axis. However, they are considered more susceptible to complications. In contrast, non-modular cemented systems are said to be more forgiving and show good long-term results. The aim of this study was to investigate the resulting leg axis after implantation of a non-modular cemented rotating hinged knee prosthesis. Furthermore, potential risk factors for the occurrence of malalignment and complications should be identified.
METHODS: Between 2005 and 2015, 115 patients could be included in this monocentric retrospective cohort study. All patients underwent primary hinged non-modular cemented total knee arthroplasty. Preoperative and postoperative standardized long radiographs were analysed to determine resulting leg axis. Furthermore, epidemiological and intraoperative data as well as perioperative complications were surveyed.
RESULTS: Average leg axis was 5.8° varus preoperatively and 0.6° valgus postoperatively. Considering an axis deviation of 3° as the target corridor, 27% of all cases examined were outside the desired range. 21% cases showed a femoral deviation from the target corridor and 15% showed a tibial deviation. There was a significant relationship between the preoperative mLDFA and the mechanical alignment of the femoral component (R = 0.396, p < 0.001) as well as between the preoperative mMPTA and the mechanical alignment of the tibial component (R = 0.187, p = 0.045). The mean operative duration was 96 min. No periprosthetic fractures were observed within the study cohort.
CONCLUSIONS: The main result of the present work is that a non-modular cemented rotating hinged knee arthroplasty system can reconstruct the mechanical leg axis precisely and comparable to modular cementless and unconstrained total knee prostheses. Component malalignment is primarily dependent upon extraarticular deformity preoperatively. Periprosthetic fracture rates and duration of surgery were lower compared with current literature.
METHODS: Level III: Retrospective cohort study.
METHODS: Between 2005 and 2015, 115 patients could be included in this monocentric retrospective cohort study. All patients underwent primary hinged non-modular cemented total knee arthroplasty. Preoperative and postoperative standardized long radiographs were analysed to determine resulting leg axis. Furthermore, epidemiological and intraoperative data as well as perioperative complications were surveyed.
RESULTS: Average leg axis was 5.8° varus preoperatively and 0.6° valgus postoperatively. Considering an axis deviation of 3° as the target corridor, 27% of all cases examined were outside the desired range. 21% cases showed a femoral deviation from the target corridor and 15% showed a tibial deviation. There was a significant relationship between the preoperative mLDFA and the mechanical alignment of the femoral component (R = 0.396, p < 0.001) as well as between the preoperative mMPTA and the mechanical alignment of the tibial component (R = 0.187, p = 0.045). The mean operative duration was 96 min. No periprosthetic fractures were observed within the study cohort.
CONCLUSIONS: The main result of the present work is that a non-modular cemented rotating hinged knee arthroplasty system can reconstruct the mechanical leg axis precisely and comparable to modular cementless and unconstrained total knee prostheses. Component malalignment is primarily dependent upon extraarticular deformity preoperatively. Periprosthetic fracture rates and duration of surgery were lower compared with current literature.
METHODS: Level III: Retrospective cohort study.
摘要：
目的：模块化无骨水泥膝关节置换系统能够精确重建机械轴。然而,他们被认为更容易出现并发症。相比之下,据说非模块化胶结系统更宽容，并显示出良好的长期效果。这项研究的目的是研究植入非模块化水泥旋转铰链膝关节假体后产生的腿轴。此外，应确定发生错位和并发症的潜在危险因素.
方法：在2005年至2015年之间，115例患者可以纳入这项单中心回顾性队列研究。所有患者均接受了原发性铰链式非模块化骨水泥型全膝关节置换术。分析了术前和术后标准化的长片，以确定所得的腿轴。此外，调查流行病学、术中数据以及围手术期并发症。
结果：术前平均腿轴为5.8°内翻，术后为0.6°外翻。考虑到3°的轴偏差作为目标走廊，所有检查的病例中有27％超出了预期范围。21%的病例显示股骨偏离目标走廊，15%的病例显示胫骨偏离。术前mLDFA与股骨组件的机械对准之间存在显着关系（R=0.396，p<0.001），术前mMPTA与胫骨组件的机械对准之间也存在显着关系（R=0.187，p=0.045）。平均手术时间为96分钟。在研究队列中未观察到假体周围骨折。
结论：本工作的主要结果是，非模块化骨水泥旋转铰链膝关节置换术系统可以精确重建机械腿轴，与模块化无骨水泥和无约束的全膝关节假体相当。组件对齐不良主要取决于术前关节外畸形。与现有文献相比，假体周围骨折率和手术持续时间较低。
方法：III级：回顾性队列研究。
方法：在2005年至2015年之间，115例患者可以纳入这项单中心回顾性队列研究。所有患者均接受了原发性铰链式非模块化骨水泥型全膝关节置换术。分析了术前和术后标准化的长片，以确定所得的腿轴。此外，调查流行病学、术中数据以及围手术期并发症。
结果：术前平均腿轴为5.8°内翻，术后为0.6°外翻。考虑到3°的轴偏差作为目标走廊，所有检查的病例中有27％超出了预期范围。21%的病例显示股骨偏离目标走廊，15%的病例显示胫骨偏离。术前mLDFA与股骨组件的机械对准之间存在显着关系（R=0.396，p<0.001），术前mMPTA与胫骨组件的机械对准之间也存在显着关系（R=0.187，p=0.045）。平均手术时间为96分钟。在研究队列中未观察到假体周围骨折。
结论：本工作的主要结果是，非模块化骨水泥旋转铰链膝关节置换术系统可以精确重建机械腿轴，与模块化无骨水泥和无约束的全膝关节假体相当。组件对齐不良主要取决于术前关节外畸形。与现有文献相比，假体周围骨折率和手术持续时间较低。
方法：III级：回顾性队列研究。
