Prótesis de pivote medial y ultra-congruente: satisfacción y resultados clínicos. Serie de casos
DOI:
https://doi.org/10.1016/j.rccot.2020.07.005Palabras clave:
artroplastia total de rodilla, pivote medial, ultra-congruente, satisfacción de pacientes, resultados clínicos, resultados reportados por pacientesResumen
Introducción: La artroplastia total de rodilla es un procedimiento exitoso que mejora significativamente la calidad de vida de los pacientes disminuyendo el dolor e incrementando su capacidad funcional. Sin embargo, la literatura reporta hasta 25% de pacientes insatisfechos. El objetivo de este estudio es presentar los resultados clínicos y la satisfacción de un grupo de pacientes operados con implantes de tipo pivote medial y ultra-congruente.
Materiales y métodos: Se realizó un estudio observacional retrospectivo. Se revisaron las historias clínicas de todos los pacientes operados con los sistemas mencionados con mínimo 12 meses post-operatorios. Se analizaron resultados de 100 rodillas (96 pacientes) que completaron los cuestionarios, con una media de seguimiento de 33.5 meses. Se aplicaron los cuestionarios KSS, KOOS y WOMAC. Se estudiaron diferencias en dolor y función entre la etapa pre-operatoria y el último seguimiento. Se analizó la satisfacción de los pacientes con respecto al dolor y la capacidad funcional. Se evaluaron complicaciones presentadas.
Resultados: Todos los criterios presentaron una mejora estadísticamente significativa entre la etapa pre-operatoria y el último seguimiento. 97% de los pacientes reportaron estar satisfechos con los resultados. Las medias de los cuestionarios fueron entre 83.97 y 95.3. Se presentó 1 caso de revisión por infección peri-protésica.
Discusión: Las prótesis de pivote medial y ultra-congruente constituyen opciones eficaces y seguras para el tratamiento de artrosis de rodilla. Es necesario realizar estudios prospectivos y comparativos que generen evidencia de más alto nivel para confirmar los beneficios de estos diseños.
Nivel de evidencia: IV
Descargas
Referencias bibliográficas
Macheras GA, Galanakos SP, Lepetsos P, Anastasopoulos PP, Papadakis SA. A long term clinical outcome of the Medial Pivot Knee Arthroplasty System. Knee. 2017;24:447-53. https://doi.org/10.1016/j.knee.2017.01.008
Parvizi J, Nunley RM, Berend KR, Lombardi AV, Ruh EL, Clohisy JC, et al. High Level of Residual Symptoms in Young Patients After Total Knee Arthroplasty. Clin Orthop Relat Res. 2014;472:133-7. https://doi.org/10.1007/s11999-013-3229-7
Gunaratne R, Pratt DN, Banda J, Fick DP, Khan RJK, Robertson BW. Patient Dissatisfaction Following Total Knee Arthroplasty: A Systematic Review of the Literature. J Arthroplasty. 2017;32:3854-60. https://doi.org/10.1016/j.arth.2017.07.021
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient Satisfaction after Total Knee Arthroplasty: Who is Satisfied and Who is Not? Clin Orthop Relat Res. 2010;468:57-63. https://doi.org/10.1007/s11999-009-1119-9
Choi Y, Ra HJ. Patient Satisfaction after Total Knee Arthroplasty. Knee Surg Relat Res. 2016 Mar 30;28:1-15, https://doi.org/10.5792/ksrr.2016.28.1.1
Gibon E, Goodman MJ, Goodman SB. Patient Satisfaction After Total Knee Arthroplasty: A Realistic or Imaginary Goal? Orthop Clin North Am. 2017;48:421-31. https://doi.org/10.1016/j.ocl.2017.06.001
Drexler M, Dwyer T, Chakravertty R, Farno A, Backstein D. Assuring the happy total knee replacement patient. Bone Joint J. 2013;95-B 11 Supple A:120-3. https://doi.org/10.1302/0301-620X.95B11.32949
Judge A, Arden NK, Cooper C, Kassim Javaid M, Carr AJ, Field RE, et al. Predictors of outcomes of total knee replacement surgery. Rheumatology. 2012;51:1804-13. https://doi.org/10.1093/rheumatology/kes075
Thambiah M, Nathan S, Seow B, Liang S, Lingaraj K. Patient satisfaction after total knee arthroplasty: an Asian perspective. Singapore Med J. 2015;56:259-63. https://doi.org/10.11622/smedj.2015074
Escobar A, García Pérez L, Herrera-Espineira ˜ C, Aizpuru F, Sarasqueta C, Gonzalez Sáenz de Tejada M, et al. Total knee replacement: Are there any baseline factors that have influence in patient reported outcomes? J Eval Clin Pract. 2017 Dec;23:1232-9. https://doi.org/10.1111/jep.12765
Nashi N, Hong CC, Krishna L. Residual knee pain and functional outcome following total knee arthroplasty in osteoarthritic patients. Knee Surgery, Sport Traumatol Arthrosc. 2015;23:1841-7. https://doi.org/10.1007/s00167-014-2910-z
Neuprez A, Delcour J, Fatemi F, Gillet P, Crielaard J, Bruyère O, et al. Patients’ Expectations Impact Their Satisfaction following Total Hip or Knee Arthroplasty Nazarian A. PLoS One. 2016 Dec 15;11:e0167911. https://doi.org/10.1371/journal.pone.0167911
Vissers MM, de Groot IB, Reijman M, Bussmann JB, Stam HJ, Verhaar JAN. Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty. BMC Musculoskelet Disord. 2010;11:121. https://doi.org/10.1186/1471-2474-11-121
Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006:35-43. https://doi.org/10.1097/01.blo.0000238825.63648.1e
Scott CEH, Bugler KE, Clement ND, MacDonald D, Howie CR, Biant LC. Patient expectations of arthroplasty of the hip and knee. J Bone Joint Surg Br. 2012;94-B:974-81. https://doi.org/10.1302/0301-620X.94B7.28219
Nakahara H, Okazaki K, Mizu-uchi H, Hamai S, Tashiro Y, Matsuda S, et al. Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren’t patients satisfied? J Orthop Sci. 2015;20:87-92. https://doi.org/10.1007/s00776-014-0671-7
Pitta M, Khoshbin A, Lalani A, Lee LY, Woo P, Westrich GH, et al. Age-Related Functional Decline Following Total Knee Arthroplasty: Risk Adjustment is Mandatory. J Arthroplasty. 2018:3-9.
Greene KA, Harwin SF. Maximizing patient satisfaction and functional results after total knee arthroplasty. J Knee Surg. 2011 Mar;24:19-24. https://doi.org/10.1055/s-0031-1275389
Dunbar MJ, Richardson G, Robertsson O. I can’t get no satisfaction after my total knee replacement. Bone Joint J. 2013;95-B 11 Supple A:148-52. https://doi.org/10.1302/0301-620X.95B11.32767
Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN, Gillespie W, et al. Knee range of motion after total knee arthroplasty: How important is this as an outcome measure? J Arthroplasty. 2003;18:286-94. https://doi.org/10.1054/arth.2003.50046
Katchky AM, Jones CW, Walter WL, Shimmin AJ. Medial ball and socket total knee arthroplasty. Bone Joint J. 2019;101-B 1 Supple A:59-65. https://doi.org/gqjnzg
Irmola T, Kangas J, Eskelinen A, Niemelaïnen M, Huhtala H, Mattila VM, et al. Functional outcome of total knee replacement: A study protocol for a prospective, double-blinded, parallel-group randomized, clinical controlled trial of novel, personalized and conventional implants. BMC Musculoskelet Disord. 2019; 20:1-8. https://doi.org/10.1186/s12891-019-2830-7
Karachalios T, Varitimidis S, Bargiotas K, Hantes M, Roidis N, Malizos KN. An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty: Pivot knee arthroplasty. Bone Joint J. 2016 Aug;98-B:1050-5. https://doi.org/10.1302/0301-620X.98B8.36208
Hamilton DF, Lane JV, Gaston P, Patton JT, MacDonald D, Simpson AHRW, et al. What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement. BMJ Open. 2013 Apr 9;3:e002525. https://doi.org/10.1136/bmjopen-2012-002525
Figueroa D, Figueroa F, Calvo R, Vaisman A, Figueroa M, Putnis S. Trends in Total Knee Arthroplasty in a Developing Region. J Am Acad Orthop Surg. 2020;28:189-93, https://doi.org/10.5435/JAAOS-D-19-00260
Chaidez-Rosales PA, Briseno-Estrada ˜ CA, Aguilera-Zepeda JM, Ilizaliturri-Sánchez VM, Ruiz-Suárez M. Artroplastía total de rodilla con inserto tibial ultracongruente. Seguimiento a dos anos. ˜ Acta ortopédica Mex. 2011;25:17-20.
Causero A, Di Benedetto P, Beltrame A, Gisonni R, Cainero V, Pagano M. Design evolution in total knee replacement: which is the future? Acta Biomed. 2014;85:5-19.
Pritchett JW. Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty. 2011 Feb;26:224-8. https://doi.org/10.1016/j.arth.2010.02.012
Lange T, Schmitt J, Kopkow C, Rataj E, Günther K, Lützner J. What Do Patients Expect From Total Knee Arthroplasty? A Delphi Consensus Study on Patient Treatment Goals. J Arthroplasty. 2017;32:2093-9. https://doi.org/10.1016/j.arth.2017.01.053
Song EK, Lim HA, Joo SD, Kim SK, Lee KB, Seon JK. Total knee arthroplasty using ultra-congruent inserts can provide similar stability and function compared with cruciate-retaining total knee arthroplasty. Knee Surgery, Sport Traumatol Arthrosc. 2017;25:3530-5. https://doi.org/10.1007/s00167-017-4553-3
Lützner J, Firmbach FP, Lützner C, Dexel J, Kirschner S. Similar stability and range of motion between cruciate-retaining and cruciate-substituting ultracongruent insert total knee arthroplasty. Knee Surgery, Sport Traumatol Arthrosc. 2015;23:1638-43. https://doi.org/10.1007/s00167-014-2892-x
Cavaliere P. De meo F. Dynamic congruence K-MOD total knee prosthesis: short-term results after 373 implants. Acta Orthop Ital. 2014:37.
Sabatini L, Risitano S, Parisi G, Tosto F, Indelli PF, Atzori F, et al. Medial Pivot in Total Knee Arthroplasty: Literature Review and Our First Experience. Clin Med Insights Arthritis Musculoskelet Disord. 2018;11, https://doi.org/10.1177/1179544117751431
Yuan D, Zhang Q-S, Zhang K, Cao Y-W, Chen G-H, Ling Z-Z, et al. Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients. J Knee Surg. 2019;1(212.). https://doi.org/10.1055/s-0039-1688784
Schmidt R, Ogden S, Blaha JD, Alexander A, Fitch DA, Barnes CL. Midterm clinical and radiographic results of the medial pivot total knee system. Int Orthop. 2014 Dec;38:2495-8. https://doi.org/10.1007/s00264-014-2444-5
Dennis DA, Komistek RD, Colwell CW, Scott RD, Thornhill TS, Ranawat CS. In vivo anteroposterior femorotibial translation: A multicenter analysis. J Arthroplasty. 1998;13:231-2. https://doi.org/10.1016/S0883-5403(98)90133-4
Draganich LF, Andriacchi TP, Andersson GBJ. Interaction between intrinsic knee mechanics and the knee extensor mechanism. J Orthop Res. 1987;5:539-47. https://doi.org/10.1002/jor.1100050409
Chinzei N, Ishida K, Tsumura N, Matsumoto T, Kitagawa A, Iguchi T, et al. Satisfactory results at 8years mean follow-up after ADVANCE® medial-pivot total knee arthroplasty. Knee. 2014;21:387-90. https://doi.org/10.1016/j.knee.2013.10.005
Barnes CL, Blaha JD, DeBoer D, Stemniski P, Obert R, Carroll M. Assessment of a medial pivot total knee arthroplasty design in a cadaveric knee extension test model. J Arthroplasty. 2012;27:1460-8, e1. https://doi.org/10.1016/j.arth.2012.02.008
Schmidt R, Komistek RD, Blaha JD, Penenberg BL, Maloney WJ. Fluoroscopic analyses of cruciate-retaining and medial pivot knee implants. Clin Orthop Relat Res. 2003:139-47. https://doi.org/10.1097/01.blo.0000063565.90853.a4
Noyes FR, Schipplein O, Andriacchi TP, Saddemi SR, Weise M. The anterior cruciate with varus alignment knee analysis of gait adaptations. Am J Sports Med. 1992;20:707-16, https://doi.org/10.1177/036354659202000612
Dennis DA, Komistek RD, Walker SA, Cheal EJ, Stiehl JB. Femoral condylar lift-off in vivo in total knee arthroplasty. J Bone Jt Surg - Ser B. 2001;83:33-9. https://doi.org/10.1302/0301-620X.83B1.0830033
Atzori F, Salama W, Sabatini L, Mousa S, Khalefa A. Medial pivot knee in primary total knee arthroplasty. Ann Transl Med. 2016;4:4-7. https://doi.org/10.21037/atm.2016.01.34
Bordini B, Ancarani C, Fitch DA. Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry. J Orthop Surg Res. 2016;11:44. https://doi.org/10.1186/s13018-016-0388-8
Devers BN, Conditt MA, Jamieson ML, Driscoll MD, Noble PC, Parsley BS. Does Greater Knee Flexion Increase Patient Function and Satisfaction After Total Knee Arthroplasty? J Arthroplasty. 2011 Feb;26:178-86. https://doi.org/10.1016/j.arth.2010.02.008
Rowe PJ, Myles CM, Walker C, Nutton R. Knee joint kinematics in gait and other functional activities measured using flexible electrogoniometry: How much knee motion is sufficient for normal daily life? Gait Posture. 2000;12:143-55. https://doi.org/10.1016/S0966-6362(00)00060-6
Keudell A, Von, Sodha S, Collins J, Minas T, Fitz W, Gomoll AH. The Knee Patient satisfaction after primary total and unicompartmental knee arthroplasty: An age-dependent analysis. Knee. 2014;21:180-4. https://doi.org/10.1016/j.knee.2013.08.004
Wimmer MA, Nechtow W, Schwenke T, Moisio KC. Knee Flexion and daily activities in patients following total knee replacement: A comparison with ISO standard 14243. Biomed Res Int. 2015:2015. https://doi.org/10.1155/2015/157541
Meneghini RM, Mont MA, Backstein DB, Bourne RB, Dennis DA, Scuderi GR. Development of a Modern Knee Society Radiographic Evaluation System and Methodology for Total Knee Arthroplasty. J Arthroplasty. 2015;30:2311-4. https://doi.org/10.1016/j.arth.2015.05.049
Ecker ML, Lotke PA, Windsor RE, Cella JP. Long-term results after total condylar knee arthroplasty Significance of radiolucent lines. Clin Orthop Relat Res. 1987:151-8. https://doi.org/10.1097/00003086-198703000-00023
Lützner J, Beyer F, Dexel J, Fritzsche H, Lützner C, Kirschner S. No difference in range of motion between ultracongruent and posterior stabilized design in total knee arthroplasty: a randomized controlled trial. Knee Surgery, Sport Traumatol Arthrosc. 2017;25:3515-21. https://doi.org/10.1007/s00167-016-4331-7
Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC. Assessing activity in joint replacement patients. J Arthroplasty. 1998;13:890-5. https://doi.org/10.1016/S0883-5403(98)90195-4
Minoda Y, Kobayashi A, Iwaki H, Miyaguchi M, Kadoya Y, Ohashi H, et al. Polyethylene wear particle generation in vivo in an alumina medial pivot total knee prosthesis. Biomaterials. 2005;26:6034-40. https://doi.org/10.1016/j.biomaterials.2005.03.022
Scott WN. Insall & Scott Surgery of the Knee E-Book. Elsevier Health Sciences;. 2011.
Carvalho Júnior LHde, Teixeira BP, Bernardes CO, da S, Soares LFM, Gonc¸alves MBJ, Temponi EF. Range of motion predictability after total knee arthroplasty with medial pivot prosthesis. Rev Bras Ortop (English Ed. 2017;52:197-202. https://doi.org/10.1016/j.rboe.2017.03.001
Nakamura J, Inoue T, Suguro T, Suzuki M, Sasho T, Hagiwara S, et al. A comparative study of flat surface design and medial pivot design in posterior cruciate-retaining total knee arthroplasty: a matched pair cohort study of two years. BMC Musculoskelet Disord. 2018;19:234. https://doi.org/10.1186/s12891-018-2138-z
Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ. Three groups of dissatisfied patients exist after total knee arthroplasty: early, persistent, and late. Bone Joint J. 2018;100-B:161-9. https://doi.org/ghbnww
Indelli PF, Marcucci M, Graceffa A, Charlton S, Latella L. Primary posterior stabilized total knee arthroplasty: Analysis of different instrumentation. J Orthop Surg Res. 2014;9: 1-5. https://doi.org/10.1186/s13018-014-0054-y
Bono JV, Scott RD. Revision total knee arthroplasty Second Edi. Orthopaedic Knowledge Update: Hip and Knee Reconstruction 5. Springer International Publishing. 2018:1-421. https://doi.org/10.1007/978-3-319-67344-8
Huten D. Femorotibial bone loss during revision total knee arthroplasty. Orthop Traumatol Surg Res. 2013;99 1 Suppl:S22-33. https://doi.org/10.1016/j.otsr.2012.11.009
Anderson MJ, Becker DL, Kieckbusch T. Patellofemoral complications after posterior-stabilized total knee arthroplasty: A comparison of 2 different implant designs. J Arthroplasty. 2002;17:422-6. https://doi.org/10.1054/arth.2002.32173
Bae DK, Song SJ, Cho S. Do. Clinical outcome of total knee arthroplasty with medial pivot prosthesis a comparative study between the cruciate retaining and sacrificing. J Arthroplasty. 2011;26:693-8. https://doi.org/10.1016/j.arth.2010.04.022
Boelch SP, Jakuscheit A, Doerries S, Fraissler L, Hoberg M, Arnholdt J, et al. Periprosthetic infection is the major indication Satisfacción y resultados clínicos de prótesis de rodilla de pivote medial 371 for TKA revision - experiences from a university referral arthroplasty center. BMC Musculoskelet Disord. 2018;19:395. https://doi.org/10.1186/s12891-018-2314-1
Frosch P, Decking J, Theis C, Drees P, Schoellner C, Eckardt A. Complications after total knee arthroplasty: A comprehensive report. Acta Orthop Belg. 2004;70:565-9.
Healy WL, Della Valle CJ, Iorio R, Berend KR, Cushner FD, Dalury DF, et al. Complications of total knee arthroplasty: Standardized list and definitions of the knee society knee. Clin Orthop Relat Res. 2013;471:215-20. https://doi.org/10.1007/s11999-012-2489-y
Malavolta M, Cochetti A, Mezzari S, Residori A, Lista G. Evaluation of Femoral-Tibial Flexion Gap in Total Knee Arthroplasty with Everted or Lateralized Patella. J Knee Surg. 2018; 1(212.). https://doi.org/10.1055/s-0038-1675422
Konno T, Onodera T, Nishio Y, Kasahara Y, Iwasaki N, Majima T. Correlation between knee kinematics and patellofemoral contact pressure in total knee arthroplasty. J Arthroplasty. 2014;29:2305-8. https://doi.org/10.1016/j.arth.2014.07.020
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Esta obra está bajo una licencia Creative Commons Reconocimiento 3.0 Unported.
Derechos de autor
Los autores aceptar transferir a la Revista Colombiana de Ortopedia y Traumatología los derechos edición, publicación y reproducción de los artículos publicados. La editorial tiene el derecho del uso, reproducción, transmisión, distribución y publicación en cualquier forma o medio. Los autores no podrán permitir o autorizar el uso de la contribución sin el consentimiento escrito de la revista. Una vez firmada por todos los autores, la carta de Cesión de derechos debe ser cargada en el paso dos del envío.
Aquellos autores que tengan publicaciones en esta revista aceptan los siguientes términos:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web), lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
