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      KCI등재 SCOPUS SCIE

      Early Outcomes of Dual-Pivot Total Knee Replacement Compared to an Ultracongruent Design

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      https://www.riss.kr/link?id=A108440173

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      다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

      Background: With a quest to optimize outcomes, there have been significant advancements in modern designs of total knee implants, attempting to mimic the natural knee motion and feel. One such new design reproducing the medial and lateral knee pivot is a dual-pivot (DP) knee. In the present study, we endeavored to compare the performance of the DP knee vis-a-vis an ultracongruent (UC) Knee design.
      Methods: This prospective cohort study was performed in a joint replacement center of a tertiary care military hospital. We enrolled 50 patients each in the DP knee group and the UC knee group and assessed knee flexion, patient-reported outcome (new Knee Society Score [nKSS]), patient performance (Delaware Osteoarthritis Profile Score), and function (Forgotten Joint Score [FJS]) at 2 years of follow-up.
      Results: The nKSS was similar in the two groups. In the DP group, patients had significantly better improvement in the stair climb test (p = 0.026). In the UC group, timed up and go test was significantly better (p = 0.004). The gain in knee flexion was similar in the two groups: 26.3° ± 23.3° in the DP group and 27.5° ± 27.5° in the UC group (p = 0.930). Return to activity as judged by 2-year FJS was similar in both groups (p = 0.687).
      Conclusions: Our study showed that the DP knee design had similar knee function to the UC knee. The DP knee design had significantly better stair climbing ability, whereas getting up from chair was better in the UC knee design. With comparable patientreported outcome and possible differences in patient performance in terms of day-to-day activities, any future trial should focus on comparing patient performance.
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      Background: With a quest to optimize outcomes, there have been significant advancements in modern designs of total knee implants, attempting to mimic the natural knee motion and feel. One such new design reproducing the medial and lateral knee pivot i...

      Background: With a quest to optimize outcomes, there have been significant advancements in modern designs of total knee implants, attempting to mimic the natural knee motion and feel. One such new design reproducing the medial and lateral knee pivot is a dual-pivot (DP) knee. In the present study, we endeavored to compare the performance of the DP knee vis-a-vis an ultracongruent (UC) Knee design.
      Methods: This prospective cohort study was performed in a joint replacement center of a tertiary care military hospital. We enrolled 50 patients each in the DP knee group and the UC knee group and assessed knee flexion, patient-reported outcome (new Knee Society Score [nKSS]), patient performance (Delaware Osteoarthritis Profile Score), and function (Forgotten Joint Score [FJS]) at 2 years of follow-up.
      Results: The nKSS was similar in the two groups. In the DP group, patients had significantly better improvement in the stair climb test (p = 0.026). In the UC group, timed up and go test was significantly better (p = 0.004). The gain in knee flexion was similar in the two groups: 26.3° ± 23.3° in the DP group and 27.5° ± 27.5° in the UC group (p = 0.930). Return to activity as judged by 2-year FJS was similar in both groups (p = 0.687).
      Conclusions: Our study showed that the DP knee design had similar knee function to the UC knee. The DP knee design had significantly better stair climbing ability, whereas getting up from chair was better in the UC knee design. With comparable patientreported outcome and possible differences in patient performance in terms of day-to-day activities, any future trial should focus on comparing patient performance.

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      참고문헌 (Reference)

      1 Lutzner J, "Ultracongruent insert design is a safe alternative to posterior cruciatesubstituting total knee arthroplasty : 5-year results of a randomized controlled trial" 30 : 3000-3006, 2022

      2 Song EK, "Total knee arthroplasty using ultra-congruent inserts can provide similar stability and function compared with cruciate-retaining total knee arthroplasty" 25 (25): 3530-3535, 2017

      3 Ackerman IN, "The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030" 20 (20): 90-, 2019

      4 Klem NR, "Satisfaction after total knee replacement for osteoarthritis is usually high, but what are we measuring? A systematic review" 2 (2): 100032-, 2020

      5 Bryan S, "Revisiting patient satisfaction following total knee arthroplasty : a longitudinal observational study" 19 (19): 423-, 2018

      6 Verhaar J, "Patient satisfaction after total knee replacementstill a challenge" 91 (91): 241-242, 2020

      7 Kahlenberg CA, "Patient satisfaction after total knee replacement : a systematic review" 14 (14): 192-201, 2018

      8 Bourne RB, "Patient satisfaction after total knee arthroplasty : who is satisfied and who is not?" 468 (468): 57-63, 2010

      9 Lizaur-Utrilla A, "Minimal clinically important differences and substantial clinical benefits for Knee Society Scores" 28 (28): 1473-1478, 2020

      10 Atzori F, "Medial pivot knee in primary total knee arthroplasty" 4 (4): 6-, 2016

      1 Lutzner J, "Ultracongruent insert design is a safe alternative to posterior cruciatesubstituting total knee arthroplasty : 5-year results of a randomized controlled trial" 30 : 3000-3006, 2022

      2 Song EK, "Total knee arthroplasty using ultra-congruent inserts can provide similar stability and function compared with cruciate-retaining total knee arthroplasty" 25 (25): 3530-3535, 2017

      3 Ackerman IN, "The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030" 20 (20): 90-, 2019

      4 Klem NR, "Satisfaction after total knee replacement for osteoarthritis is usually high, but what are we measuring? A systematic review" 2 (2): 100032-, 2020

      5 Bryan S, "Revisiting patient satisfaction following total knee arthroplasty : a longitudinal observational study" 19 (19): 423-, 2018

      6 Verhaar J, "Patient satisfaction after total knee replacementstill a challenge" 91 (91): 241-242, 2020

      7 Kahlenberg CA, "Patient satisfaction after total knee replacement : a systematic review" 14 (14): 192-201, 2018

      8 Bourne RB, "Patient satisfaction after total knee arthroplasty : who is satisfied and who is not?" 468 (468): 57-63, 2010

      9 Lizaur-Utrilla A, "Minimal clinically important differences and substantial clinical benefits for Knee Society Scores" 28 (28): 1473-1478, 2020

      10 Atzori F, "Medial pivot knee in primary total knee arthroplasty" 4 (4): 6-, 2016

      11 Bordini B, "Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry" 11 : 44-, 2016

      12 Nilsdotter AK, "Knee arthroplasty:are patients’ expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up" 80 (80): 55-61, 2009

      13 Hossain F, "Knee arthroplasty with a medially conforming ball-and-socket tibiofemoral articulation provides better function" 469 (469): 55-63, 2011

      14 Ellisa HB, "Influence of socioeconomic status on outcome of joint replacement surgery" 21 (21): 132-137, 2010

      15 Mikashima Y, "In vivo deepflexion kinematics in patients with posterior-cruciate retaining and anterior-cruciate substituting total knee arthroplasty" 25 (25): 83-87, 2010

      16 Banks SA, "Implant design affects knee arthroplasty kinematics during stair-stepping" (426) : 187-193, 2004

      17 Dunbar MJ, "I can’t get no satisfaction after my total knee replacement : rhymes and reasons" 95 (95): 148-152, 2013

      18 Kulshrestha Vikas ; Sood Munish ; Kanade Sarang ; Kumar Santhosh ; Datta Barun ; Mittal Gaurav, "Early Outcomes of Medial Pivot Total Knee Arthroplasty Compared to Posterior-Stabilized Design: A Randomized Controlled Trial" 대한정형외과학회 12 (12): 178-186, 2020

      19 Sandberg R, "Dual-pivot bearings improve ambulation and promote increased activity levels in total knee arthroplasty : a match-controlled retrospective study" 26 (26): 1243-1249, 2019

      20 Causero A, "Design evolution in total knee replacement:which is the future?" 85 (85): 5-19, 2014

      21 Kulshrestha V, "DVT prophylaxis after TKA : routine anticoagulation vs risk screening approach : a randomized study" 28 (28): 1868-1873, 2013

      22 Banks SA, "Achieving more natural motion, stability, and function with a dual-pivot ACL-substituting total knee arthroplasty design" 33 (33): 48-51, 2018

      23 Meneghini RM, "A dual-pivot pattern simulating native knee kinematics optimizes functional outcomes after total knee arthroplasty" 32 (32): 3009-3015, 2017

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