非骨水泥型全膝关节置换术中胫骨倾斜度与胫骨后倾斜度之间的关联，而非磨损：一项为期五年的放射立体测量研究的二次分析

摘要(中文译文)

本研究的主要目的是评估非骨水泥型保留交叉韧带髁稳定型全膝关节置换术（TKA）后，术后胫骨后倾角对五年胫骨假体迁移和磨损的影响。次要目的包括术后后倾角与临床和功能结局之间的关联。本观察性研究是一项关于插入物材料的随机对照试验的二次分析，共纳入93例TKA。使用放射立体测量分析在术后3、6、12、24和60个月时，对三个术后后倾角组（小（≤ 5°）、中（6°至9°）和大（≥ 10°））的胫骨假体迁移和插入物磨损进行测量。患者报告结局指标在术前及所有随访时间点收集。胫骨假体迁移与术后胫骨后倾角之间存在关联：术后胫骨后倾角最大的组表现出最大的后倾。在五年时，小、中、大后倾角组之间的插入物磨损无差异。术后后倾角与功能结局或患者报告结局之间也无关联。后倾角超过10°植入的TKA表现出胫骨假体迁移和后倾增加，且独立于原生后倾角。在五年时，后倾角对磨损或功能结局无影响。

Abstract

The primary objective of this study was to evaluate the influence of postoperative slope on the five-year tibial component migration and wear following uncemented cruciate-retaining condylar-stabilized total knee arthroplasty (TKA). Secondary objectives included the association between postoperative slope and clinical and functional outcomes. This observational study was a secondary analysis of a randomized controlled trial of 93 TKAs on insert materials. Tibial component migration and insert wear were measured across three postoperative slope groups (small (≤ 5°), intermediate (6° to 9°), and large (≥ 10°)) using radiostereometric analysis at three, six, 12, 24, and 60 months postoperatively. Patient-reported outcome measures were collected preoperatively and at all follow-up timepoints. There was an association between tibial component migration and postoperative tibial slope: the group with the largest postoperative tibial slope showed the largest posterior tilting. At five years, there was no difference in insert wear between the small, intermediate, and large slope groups. There was also no association between postoperative slope and functional or patient-reported outcomes. TKA implanted with more than 10° of slope showed increased tibial component migration and posterior tilting, independent of the native slope. At five years, there was no influence of slope on wear or functional outcomes.

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