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单髁膝关节置换术。一项至少15年的随访研究。

Unicompartmental knee replacement. A minimum 15 year followup study.

作者信息

Squire M W, Callaghan J J, Goetz D D, Sullivan P M, Johnston R C

机构信息

Department of Orthopaedic Surgery, University of Iowa College of Medicine, Iowa City 52242, USA.

出版信息

Clin Orthop Relat Res. 1999 Oct(367):61-72.

Abstract

One hundred forty Marmor cemented unicompartmental knee replacements were inserted in 103 patients between 1975 and 1982. Fifty-two patients were women and 51 were men. One hundred twenty-five were medial compartment knee replacements and 15 were lateral knee replacements. At minimum 15 year followup 34 patients with 48 knee replacements were living; only four patients with four knee replacements were lost to followup. Average preoperative and final followup Hospital for Special Surgery knee scores were 57 and 82 points, respectively for the knees of living patients. Average preoperative and final followup Knee Society clinical and Knee Society functional scores were 31 and 42, and 85 and 71 points, respectively. For all knees, 10.2% (14 knees) were revised [4.4% (six knees) for tibial loosening, 5.1% (seven knees) for disease progression, and .7% (one knee) for pain]. For patients living 15 years, 12.5% (six knees) were revised [2.1% (one knee) for tibial loosening, and 10.4% (five knees) for disease progression]. Revision for failure of fixation of these unicompartmental replacements was comparable with that reported for fixed bearing total knee replacement. Disease progression (46%; 62 of 136 knees) and tibial subsidence with wear (10.4%; 15 of 136 knees, five of which required revision) were the major long term problems in this group of patients.

摘要

1975年至1982年间,103例患者接受了140例Marmor骨水泥单髁膝关节置换术。其中女性52例,男性51例。内侧间室膝关节置换125例,外侧膝关节置换15例。至少随访15年,48例膝关节置换的34例患者仍在世;仅4例膝关节置换的4例患者失访。在世患者膝关节术前和末次随访时特种外科医院膝关节评分平均分别为57分和82分。膝关节协会临床评分和膝关节协会功能评分术前和末次随访时平均分别为31分和42分,以及85分和71分。所有膝关节中,10.2%(14个膝关节)进行了翻修[胫骨松动4.4%(6个膝关节),疾病进展5.1%(7个膝关节),疼痛0.7%(1个膝关节)]。存活15年的患者中,12.5%(6个膝关节)进行了翻修[胫骨松动2.1%(1个膝关节),疾病进展10.4%(5个膝关节)]。这些单髁置换术固定失败的翻修情况与报道的固定平台全膝关节置换术相当。疾病进展(46%;136个膝关节中的62个)和胫骨磨损性下沉(10.4%;136个膝关节中的15个,其中5个需要翻修)是该组患者的主要长期问题。

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