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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2024; 65(02): e78-e84
DOI: 10.1055/s-0044-1789017
Artículo Original | Original Article

Artroplastía total de rodilla en desejes coronales >15°: Comparación de resultados a corto plazo entre el uso de componentes primarios versus semiconstreñidos

Article in several languages: español | English
Alex Vaisman
1   Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
,
Zoy Anastasiadis 
2   Hospital Padre Hurtado, Santiago, Chile
3   Clínica Las Condes, Santiago, Chile
,
Rodrigo Guiloff
1   Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
4   Hospital Sótero Del Río, Santiago, Chile
,
Carlos Valderrama
2   Hospital Padre Hurtado, Santiago, Chile
,
Sergio Arellano
1   Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
2   Hospital Padre Hurtado, Santiago, Chile
,
Diego Edwards
1   Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
5   Hospital de La Florida, Santiago, Chile
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Resumen

Objetivo Comparar los resultados clínicos e imagenológicos de pacientes con desejes coronales en varo o valgo sometidos a prótesis de rodilla estabilizada posterior (EP) versus implantes semiconstreñidos (SC).

Métodos Estudio retrospectivo de pacientes con alineamiento mecánico (AM) > 15°, sometidos a prótesis EP o SC. Todos los procedimientos fueron realizados en el mismo centro entre 2004 y 2018. La decisión fue determinada por parámetros clínicos, radiológicos e intraoperatorios. Pacientes con seguimiento incompleto o menor a 1 año fueron excluidos. Datos demográficos, deformidad pre y postoperatoria, complicaciones y resultados funcionales fueron evaluados a través de ficha clínica.

Resultados 39 cumplieron criterios de selección. Grupo EP: 27 pacientes, edad promedio 69 años [49-82]; 59,3% varo y 40,7% valgo. Grupo SC: 12 pacientes, edad promedio 69.3 años [41-89]; 33,3% varo y 66,7% valgo. Sin estadística significativa respecto a datos demográficos ni AM. Seguimiento promedio PS = 49,1 meses / SC= 22 meses. Escala de KOOS fue 74,1 para EP y 85,2 para SC (p > 0,05). Escala de WOMAC fue significativamente mejor en grupo SC. El RM promedio postoperatorio fue EP= activo: 1,9°-101°; pasivo: 1,6°- 108,4° /SC= activo: 2,5-110°, pasivo: 1,9-117°. Se encontró diferencia estadística significativa para flexión activa (p = 0.03) y pasiva (p = 0.04) en SC. Corrección de la AM fue EP= 14,9 [3°-31°] / SC = 19° [13°-28°] (p = 0.09). No se reportaron complicaciones tromboembólicas ni infecciosas.

Conclusión Prótesis de rodilla EP y SC son opciones válidas para pacientes con desejes coronales >15°. La escala de WOMAC y flexión muestra resultados significativamente mejores con prótesis SC a casi dos años de seguimiento.

Nivel de Evidencia IV.

Palabras Clave

rodilla - reemplazo de rodilla - deformidad severa - semiconstreñido - reemplazo primario


Publication History

Received: 05 October 2022

Accepted: 01 July 2024

Article published online:
25 September 2024

© 2024. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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