背景:由于个性化的膝关节对准策略偏离了在严格的机械轴上植入组件,因此非骨水泥全膝关节置换术(TKA)的患病率正在增加。这项回顾性研究评估了74例连续非胶结无限制运动学TKA手术的结果。
方法:这项研究包括2021年至2023年由一名外科医生在三级学术医疗中心进行的74个连续的非胶结运动学TKA。所使用的技术是不受限制的股骨第一卡尺运动学TKA。结果包括修订,疼痛评分,和射线照相测量。
结果:在执行的74个程序中,与TKA相关的问题没有修订或重新入院。平均随访时间为17.6个月,74%的患者术后随访超过1年。手术那天,术后测量显示,平均胫骨机械,股骨远端,解剖胫骨股角度为3.3°,7.7°,5.8°,分别。最初观察到5个膝盖,有射线不透性的迹象,所有这些都由最近的任命解决。膝盖没有射线照相松动。在患者中,65%,19%,16%的人报告没有疼痛,轻微的疼痛,和一些疼痛,分别,在为期6周的随访中。这提高到78%,19%,以及最近一次随访的3%。
结论:结合运动对准与非骨水泥固定显示了良好的临床和影像学结果,短期生存。尽管运动对准和非胶结TKA的使用一直存在争议,这些早期数据提示非胶结运动TKA是安全有效的.
BACKGROUND: The prevalence of noncemented total knee arthroplasty (TKA) is increasing as personalized knee alignment strategies deviate from implanting components on a strict mechanical axis. This retrospective study evaluated the outcomes of 74 consecutive noncemented unrestricted kinematic TKA procedures.
METHODS: This study included 74 consecutive noncemented kinematic TKAs performed by one surgeon at a tertiary academic medical center from 2021 to 2023. The technique used was unrestricted femur-first caliper kinematic TKA. The outcomes included revision, pain scores, and radiographic measurements.
RESULTS: Of the 74 procedures performed, there were no revisions or readmissions for problems related to TKA. The mean follow-up was 17.6 months, with 74% of patients being followed up for more than 1 year postoperatively. On the day of surgery, postoperative measurements showed that the average tibial mechanical, distal femoral, and anatomic tibiofemoral angles were 3.3°, 7.7°, and 5.8°, respectively. 5 knees were observed initially with signs of radiolucency, which all resolved by the most recent appointment. None of the knees was radiographically loose. Of the patients, 65%, 19%, and 16% reported no pain, minimal pain, and some pain, respectively, at the 6-week follow-up visit. This improved to 78%, 19%, and 3% at the most recent follow-up.
CONCLUSIONS: Combining kinematic alignment with noncemented fixation showed excellent clinical and radiographic outcomes with short-term survivorship. Although the use of both kinematic alignment and noncemented TKAs has been controversial, these early data suggest that noncemented kinematic TKA is safe and effective.