Low local curvature index and history of previous surgery are risk factors for revision in focal metallic inlay implants.

Autor: Veizi E; Ankara City Hospital, Department of Orthopedics and Traumatology, 06000 Ankara, Turkey. Electronic address: dr.nad89@hotmail.com., Güven Ş; Ankara City Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey., Naldöven ÖF; Ankara City Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey., Çepni Ş; Ankara City Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey., Çay N; Yıldırım Beyazıt University, Faculty of Medicine, Ankara City Hospital, Department of Radiology, Ankara, Turkey., Işık Ç; Memorial Ataşehir Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey., Bozkurt M; Ankara Acıbadem Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2023 Aug; Vol. 43, pp. 42-50. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1016/j.knee.2023.05.003
Abstrakt: Background: Focal chondral defects are debilitating lesions with poor healing potential. Focal metallic inlay implants were developed as a salvage procedure, whose reoperation causes and risk factors for revision are still debatable. The aim of this study is to analyze the local subchondral curvature matching of focal metallic inlay implants and its effects on survival and clinical results.
Methods: Patients operated with a knee focal metallic inlay resurfacing implant between 2014 and 2017 were eligible. Surgery was indicated for painful, focal, full-thickness cartilage lesions that had failed alternative treatments. Inclusion criteria were patients treated for a lesion ≤ 5 cm 2 in the femoral condyle, aged 40-65 years, with complete surgical records and a knee CT scan. The curvature index (K index ) was calculated as the ratio of the mean curvature of the implant (K 1 ) to the mean curvature of the subchondral bone (K 2 ).
Results: Sixty-nine patients were included, of which 60.9% were female. Mean age was 54.8 ± 6.0. Seven patients (10.1%) underwent revision surgery. When adjusted for age and sex, lesion size was not significantly correlated to revision in a multivariate regression model, while previous surgery and smaller K index were. A positive history for previous surgery was significantly correlated with worse clinical outcomes in surviving patients.
Conclusion: A positive history of previous knee surgery and a low local curvature index are risk factors for revision after focal metallic inlay implant resurfacing. Patients with a history of knee surgery should be counseled on the advantages and disadvantages before undergoing a focal resurfacing procedure.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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