Influence of the Different Prosthesis Designs on Subjective Functional Evaluation after TKA: Medium-Term Outcome Using the 2011 Knee Society Score

摘要

Background: Patient-reported outcome ( PRO ) ha s become the focus of increased attention in the assessment of total knee arthroplasty (TKA). The purpose of this study was to investigate whether different prosthesis designs affected postoperative patient-reported performance. Materials and Methods: We reviewed 216 patients (234 knees) implanted with the Press-Fit Condylar Sigma prosthesis at our institution between January 2009 and December 2011. This study included 76 knees with fixed-bearing cruciate-retaining (FB-CR), 78 knees with fixed-bearing posterior-stabilized (FB-PS), and 80 knees with mobile-bearing posterior-stabilized (MB-PS) designs. The mean follow-up was 8.0 ± 0.74 years. Preoperative and follow-up ratings according to the 2011 Knee Society Score (2011 KSS), range of motion (ROM), and standing femoro-tibial angle (FTA) were obtained for all patients. Additionally, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were collected at last follow-up. Results: Three separate subscales of the 2011 KSS of the three cohorts were significantly improved post-operatively compared to the pre-operative values ( p < 0.05), except for expectation scores. At the time of follow-up, significantly higher the 2011 Knee Society Functional Scores ( P = 0.016) were found in the PS group. In particular, there w ere significant differences in advanced activities of the 2011 KSFS among the three groups ( P = 0.017). Satisfaction scores showed no difference among the three groups ( P = 0.251). On the other hand, WOMAC and expectation scores were significantly better in the PS groups. ( P = 0.003, P = 0.004). ROM in the MB-PS group (124.0 ° ) was better than that in FB-PS (119.4 ° ) and FB-CR (118.9 ° ) ( P = 0.005). On the other hand, additional surgery was needed in five PS knees. Conclusion: The PS prostheses had superior 2011 KSFS, expectation scores, WOMAC scores and ROM than the CR prostheses. In contrast, the postoperative prosthesis-related complication rates were lower with CR prostheses. Further detailed evaluation is necessary to determine whether the characteristics of the different prostheses affect PRO.