Rorabeck C H
London Health Sciences Centre, University of Western Ontario, London.
Can J Surg. 1999 Feb;42(1):21-6.
To compare the complication rates associated with total knee arthroplasty against the types of fixation (hybrid or cemented), using a single total knee design (the anatomic modular knee [AMK] prosthesis).
A prospective, nonrandomized, controlled trial.
University Hospital in London, Ont., a tertiary care teaching centre.
Two groups made up of 484 knees in 395 patients (89 bilateral).
In 260 knees a hybrid configuration (cemented tibia and noncemented femur) was used (group 1). In 224 knees the femoral and tibial components were cemented (group 2). All patellae were cemented in both groups.
Clinical results were assessed by The Knee Society Clinical Rating Scores at 3 months, 6 months and yearly intervals. Radiographic results were determined by 3-foot standing radiographs and at each follow-up visit standing knee radiographs, lateral and skyline views. Radiographs were analysed for alignment, presence or absence of radiolucent lines or changes in the position of the implant. All reoperations and nonoperative complications were recorded.
At an average follow-up of 4.8 years, 8 knees (1.6%) required reoperation. An analysis of the complications leading to reoperation demonstrated no difference between the 2 groups.
There was no difference in outcome whether the femoral component was cemented or not. Medium-term results of the AMK are excellent with a very low reoperation rate.
使用单一全膝关节设计（解剖型模块化膝关节[AMK]假体），比较全膝关节置换术与固定类型（混合型或骨水泥型）相关的并发症发生率。
一项前瞻性、非随机、对照试验。
安大略省伦敦市的大学医院，一家三级医疗教学中心。
两组由395例患者（89例双侧）的484个膝关节组成。
260个膝关节采用混合型配置（胫骨骨水泥固定和股骨非骨水泥固定）（第1组）。224个膝关节的股骨和胫骨组件采用骨水泥固定（第2组）。两组所有髌骨均采用骨水泥固定。
在3个月、6个月和每年的间隔时间，通过膝关节协会临床评分对临床结果进行评估。通过3英尺站立位X线片以及每次随访时的站立位膝关节X线片、侧位和髌股关节切线位片确定影像学结果。对X线片进行分析，以评估对线情况、是否存在透亮线或植入物位置的变化。记录所有再次手术和非手术并发症。
平均随访4.8年，8个膝关节（1.6%）需要再次手术。对导致再次手术的并发症分析表明，两组之间无差异。
股骨组件是否采用骨水泥固定，结果无差异。AMK的中期结果极佳，再次手术率非常低。
