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在双边同步全膝关节整形术中,超相对应的与交叉保持插件相比:一个前性的随机对照试验
Kushagra Pathak1, Sahil Batra1, Arpit Sahu2
1Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi New Delhi 110029, India.
The Journal of arthroplasty
|February 11, 2026
概括
在全膝关节整形手术中,与十字状保持 (CR) 插件相比,超合并 (UC) 膝关节插件显著改善了患者的满意度. 这种在联合意识方面的主观益处没有得到客观的临床或步态分析措施的支持.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 假肢设计 假肢设计
背景情况:
- 整膝关节整形 (TKA) 假肢设计旨在复制本地膝关节功能.
- 基于患者报告和客观结果,关于不同TKA插件设计 (例如,超一致与交叉保留) 的有效性存在相互矛盾的证据.
- 了解TKA插件设计之间的患者满意度差异对于优化手术结果至关重要.
研究的目的:
- 为了在双边同时的TKA中比较超一致 (UC) 和交叉保持 (CR) 插件设计之间的患者满意度.
- 调查客观参数,可以解释UC和CR TKA插件之间观察到的结果差异.
主要方法:
- 一个前性的,随机的,双盲的I级试验,涉及53名接受双边同时TKA的患者.
- 患者在一条膝盖上获得随机分配的UC插件,在另一条膝盖上获得CR插件.
- 主要结局:遗忘关节评分 (FJS);次要结局:牛津膝关节评分 (OKS),膝关节协会评分 (KSS),步态分析和多次术后间隔 (3,12,24个月) 的稳定性评估.
主要成果:
- 与CR插入组相比,UC插入组在所有术后时间点都显示出明显优异的遗忘关节分数 (FJS) (P<0.05).
- 在FJS中最大的差异是在一年的随访中观察到的 (UC: 73.2 ± 6.0与CR相比:67.5 ± 16.6;P = 0.007).
- 对于其他评估的临床,放射学或步态参数,UC和CR组之间没有发现统计学上显著的差异.
结论:
- 超合并 (UC) 插件提供显著更好的患者报告的关节意识 (FJS) 与十字状保持 (CR) 插件相比,TKA后长达2年.
- 使用UC插件增强的主观患者结局并未通过客观的临床或生物力学测量得到证实.
- UC插件在PCL牺牲的TKA中代表了CR插件的可行替代品,提供了患者感知到的改善的关节功能.
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