OUTCOMES OF LINER EXCHANGE VERSUS COMPONENT REVISION FOR THE TREATMENT OF STIFFNESS FOLLOWING TOTAL KNEE ARTHROPLASTY
Notice bibliographique
Résumé
The optimal surgical management for stiffness post total knee replacement (TKA) remains controversial and there is a paucity of evidence evaluating the outcomes of liner exchange (LE) versus component revision (CR). The aim of this study was to compare the outcomes of revision TKA (rTKA) with arthrolysis and LE versus CR for the treatment of stiffness post TKA. Primary outcomes were achievement of a successful range of movement (ROM) and improvement in arc of motion (AOM). Secondary outcomes included survival free from all-cause and stiffness re-revision, as well patient-reported outcomes. We retrospectively reviewed our institutional database to identify all rTKA performed for stiffness in patients post primary TKA between 2005 and 2021. Patients with less than two-year follow-up, loose components, or infection were excluded. A total of 129 rTKA for stiffness were included; 91 (71%) LE and 38 (29%) CR. Mean patient age was 63.1, BMI was 30.6, and 60% were female. The mean follow-up was 8.5 years (range two-21). The LE and CR cohorts had similar patient age (p=0.83), BMI (p=0.99), sex (p=0.99), previous manipulation (p=0.45), time from primary TKA (p=0.14), and pre rTKA AOM (p=0.08). Achievement of a successful ROM was defined as flexion ≥ 90 degrees with extension deficit of ≤ 10 degrees at final follow-up. Primary ROM outcomes and the Forgotten Joint Score (FJS) were compared between LE and CR cohorts. Kaplan-Meier analysis was used to determine survival free from re-revision for the entire cohort and between cohorts. For the entire cohort, 69% (82) achieved a successful ROM post rTKA and the mean AOM improved (63.2 to 88.5, p < 0 .001). Achievement of a successful ROM post rTKA was similar for the LE (72%) and CR (62%) cohorts (p=0.29). The mean gain in AOM was also similar between the LE (24.9 degrees, range -65 to 70) and CR (25.4 degrees, range -40 to 70) cohorts (p=0.45). Seventeen (13%) patients underwent an all-cause re-revision. The 10-year all-cause re-revision free survival was 84.7% (SE 3.6%) for the entire cohort and similar between the LE (86.2%) and CR (81.1%) cohorts (p=0.55). There were 11 (9%) re-revisions for stiffness for the entire cohort. The survival from re-revision for stiffness was 90.2% (SE 2.9%) at 10-years for the entire cohort, and similar for the LE (91.6%) and CR (86.7%) cohorts (p=0.6). The mean FJS was 23.4 (range zero-91.7) at final follow-up and only 43.2% achieved a patient acceptable symptom state. The mean FJS was similar between cohorts (p=0.14), but the LE cohort achieved a higher proportion of acceptable symptoms than the CR cohort (56% vs. 10%, p=0.03). Revision TKA for stiffness resulted in modest gains in ROM and a reasonable 10-year re-revision free survival, however, functional outcomes and patient satisfaction were poor. LE resulted in similar achievement of a successful ROM, re-revision free survival, and FJS compared with CR, but a better acceptable symptom state. Our results suggest that when indicated, liner exchange is a reasonable option for the treatment of stiffness after TKA.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».