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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Twelve Year Outcomes of Oxinium Total Knee Arthroplasty Compared to the Same Cobalt Chrome Prosthesis
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Twelve Year Outcomes of Oxinium Total Knee Arthroplasty Compared to the Same Cobalt Chrome Prosthesis

机译：与相同的钴铬假体相比，全膝关节置换术的十二年结果

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Introduction: Alternative bearings surfaces to Cobalt Chrome (Co-Cr), such as Oxidised have been introduced in an attempt to reduce polyethylene wear and hence decrease TKA loosening and lysis. While non-comparative reports have been described as promising, no short or long term clinical studies exists showing the superiority of Oxinium on a polyethylene bearing surfaces. In this study, we investigate the long-term outcomes of Oxinium and Co-Cr TKR in a “like for like” or matched cohort analysis of the Genesis II design (Smith & Nephew, Memphis, TN, USA). Using data from a large national joint replacement registry we selected cohorts that used only the cruciate retaining design, with the same method of fixation and polyethylene type, differing only in the femoral component bearing surfaces. Our primary hypothesis was that Oxinium TKA would have a lower cumulative percent revision than the same Co-Cr prosthesis at 12 years for all causes of revision. Our secondary hypothesis was that Oxinium TKA would have a lower loosening/ lysis rate and lower rate of non-infective revision than the same Co-Cr prosthesis at 12 years. Methods: Cumulative percent revision and revision diagnosis data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) from 1 September 1999, until 31 December 2013. Results: At 12 years the cumulative percent revision of the Co-Cr Genesis II of 4.8 % (95%: CI 4.2, 5.4) for all causes was not statistically different to the Oxinium Genesis II CPR of 7.7 % (95%: CI 6.2, 9.5) (For the entire period, Hazard Ratio = 1.09 (95%: CI 0.92, 1.29), p = 0.329). The CPR for all causes was not different in the under 55 years old age group (Figure 3) (HR= 1.06 (0.68, 1.66) p=0.798).). Subgroup analysis of the CPR for loosening /lysis in both groups overall was not different (HR= 0.87 (95%: CI 0.61, 1.26), p = 0.461) Subgroup analysis of all causes of revisions excluding infection in both groups overall was not different (HR = 0.87 (95%: CI 0.71, 1.06), p = 0.155) . No difference in CPR was found between the Oxinium and Co-Cr groups for any age category for all causes of revision, loosening/lysis or non-infective causes, except for loosening/lysis in the >75 years old group (p=0.033). In these patients, Oxinium TKA had a higher CPR due to uncertain reasons. Conclusions: In this AOANJRR age stratified matched cohort study, Oxinium femoral components did not reduce revision rates due to all causes, loosening/lysis or when infection as a cause of revision was removed, compared to the same Co-Cr femoral component, across all age groups including patients who were under 55 years of age.
机译：简介：已引入替代钴铬合金（Co-Cr）的轴承表面，例如氧化膜，以减少聚乙烯的磨损，从而减少TKA的松动和裂解。尽管非比较性的报道被认为是有前途的，但没有短期或长期的临床研究表明Oxinium在聚乙烯表面具有优越性。在这项研究中，我们以创世纪II设计（史密斯和侄子，孟菲斯，田纳西州，美国）的“按喜好好”或配对的队列分析研究了Oxinium和Co-Cr TKR的长期结果。使用来自大型国家联合置换登记处的数据，我们选择了仅使用十字形保持设计，具有相同的固定方法和聚乙烯类型的队列，仅在股骨成分支承表面上有所不同。我们的主要假设是，在所有修订的原因下，Oxinium TKA在12年时的累积修订百分比均低于相同的Co-Cr假体。我们的第二个假设是，与相同的Co-Cr假体相比，Oxinium TKA在12年时的松动/裂解率和非感染性翻修率均较低。方法：从1999年9月1日至2013年12月31日，从澳大利亚骨科协会国家联合置换登记处（AOANJRR）获得累积的修订和修订诊断百分比数据。结果：在12年内，Co-Cr Genesis II的累积修订百分比所有原因的4.8％（95％：CI 4.2，5.4）与Oxinium Genesis II CPR的7.7％（95％：CI 6.2，9.5）差异无统计学意义（在整个期间，危害比= 1.09（95％： CI 0.92，1.29），p ＝ 0.329）。在55岁以下的年龄组中，所有原因的CPR均无差异（图3）（HR = 1.06（0.68，1.66）p = 0.798）。两组的总体CPR松弛/溶解的亚组分析没有差异（HR = 0.87（95％：CI 0.61，1.26），p = 0.461）两组的除感染以外的所有翻修原因的亚组分析总体上没有差异（HR ＝ 0.87（95％：CI 0.71，1.06），p ＝ 0.155）。在任何年龄类别的Oxinium和Co-Cr组之间，没有发现CPR的任何差异，所有原因都是翻修，松动/溶解或非感染性原因，但> 75岁组的松动/溶解除外（p = 0.033） 。在这些患者中，由于不确定的原因，Oxinium TKA的CPR较高。结论：在该AOANJRR年龄分层配对队列研究中，与所有Co-Cr股骨组件相比，Oxinium股骨组件并未因所有原因，松动/溶解或去除感染而导致的翻修率降低。年龄组，包括55岁以下的患者。

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