Ackroyd C E, Whitehouse S L, Newman J H, Joslin C C
Bristol Knee Group, Winford Unit, Avon Orthopaedic Centre, Westbury on Trym, Bristol, England.
J Bone Joint Surg Br. 2002 Jul;84(5):667-72. doi: 10.1302/0301-620x.84b5.12404.
We have studied the long-term outcome of 408 primary medial St Georg Sled unicompartmental arthroplasties of the knee and 531 primary Kinematic total knee arthroplasties using survivorship analysis. The operations were performed by a number of surgeons under the supervision of two consultants at one orthopaedic centre. Prospective clinical assessment was carried out before and at 2, 5, 8, 10, 12 and 15 years after operation. Failure was defined as follows: revision or removal of the implant; the presence of moderate or severe pain; or 'worst-case' with all patients lost to follow-up. Cumulative survival rates at ten years were calculated using life tables. The follow-up rate was 97%. At ten years, 25 medial sled arthroplasties and 20 Kinematic knee arthroplasties had been revised. With revision or removal as the survivorship endpoint at ten years there was a success rate of 87.5% for the medial sled and 89.6% for the Kinematic knee arthroplasty. When moderate or severe pain was included these rates became 79.4% for both arthroplasties. There was no statistically significant (p > 0.05) difference between the rates of survival for the two arthroplasties using either of the endpoint criteria. Good or excellent results were recorded for 77.9% of the medial sled knees and 75.1% for the Kinematic knees. The former had 93.8% of cases with a final range of movement in excess of 90 degrees compared with 83.7% for the Kinematic knees (p < 0.01). We conclude that at a single orthopaedic centre in the UK, the St Georg Sled medial compartment arthroplasty for appropriate specific indications offers predictable survivorship at ten years which is comparable with that of the Kinematic total knee arthroplasty.
我们采用生存分析方法，研究了408例原发性内侧圣乔治雪橇式单髁膝关节置换术和531例原发性运动型全膝关节置换术的长期疗效。这些手术由多名外科医生在一名骨科中心的两名顾问的监督下进行。在术前以及术后2年、5年、8年、10年、12年和15年进行前瞻性临床评估。失败的定义如下：植入物翻修或取出；存在中度或重度疼痛；或“最坏情况”，即所有患者失访。使用生命表计算十年时的累积生存率。随访率为97%。十年时，25例内侧雪橇式关节置换术和20例运动型膝关节置换术进行了翻修。以翻修或取出作为十年时的生存终点，内侧雪橇式关节置换术的成功率为87.5%，运动型膝关节置换术的成功率为89.6%。当纳入中度或重度疼痛时，两种关节置换术的这些比率均变为79.4%。使用任何一种终点标准，两种关节置换术的生存率之间均无统计学显著差异（p>0.05）。内侧雪橇式膝关节77.9%的结果为良好或优秀，运动型膝关节为75.1%。前者93.8%的病例最终活动范围超过90度，而运动型膝关节为83.7%（p<0.0）。我们得出结论，在英国的一个骨科中心，针对适当的特定适应症进行的圣乔治雪橇式内侧间室关节置换术在十年时具有可预测的生存率，与运动型全膝关节置换术相当。
