Keating E Michael, Meding John B, Faris Philip M, Ritter Merrill A
The Center for Hip and Knee Surgery, St. Francis Hospital-Moresville, IN 46158, USA.
Clin Orthop Relat Res. 2002 Nov(404):34-9. doi: 10.1097/00003086-200211000-00007.
The purpose of the current study was to evaluate and determine the mechanism and etiology of failure of components that failed in long-term followup of Anatomic Graduated Component total knee replacements. The authors previously reported the survivorship of 4583 Anatomic Graduated Component total knee arthroplasties done during a 17-year period. The current study was done to evaluate the etiology and cause of failure of the components that failed. There were six (0.18%) failures of the femoral component. There were 21 tibia components that failed (0.46%). Twelve tibial components failed because of an osteonecrotic lesion in the medial tibia plateau. The clinical survival rate with revision or loosening of one or more components was 98.9% at 15 years. No component was revised for polyethylene wear or osteolysis. This total knee replacement has proved to have minimal wear and excellent longevity with time with no revisions between 10 and 15 years despite having nearly flat-on-flat geometry and retaining the posterior cruciate ligament. The most common cause for revision (12 tibial components) was because of an osteonecrotic lesion in the medial tibia plateau, which developed after surgery and led to loosening.
本研究的目的是评估并确定在解剖型渐变组件全膝关节置换术的长期随访中出现故障的组件的失效机制和病因。作者此前报告了在17年期间进行的4583例解剖型渐变组件全膝关节置换术的生存率。本研究旨在评估失效组件的病因和失败原因。股骨组件有6例（0.18%）出现故障。有21个胫骨组件出现故障（0.46%）。12个胫骨组件因胫骨内侧平台的骨坏死病变而失效。在15年时，一个或多个组件进行翻修或松动的临床生存率为98.9%。没有组件因聚乙烯磨损或骨溶解而进行翻修。尽管该全膝关节置换术几乎是平面贴合的几何形状并保留了后交叉韧带，但随着时间的推移，已证明其磨损极小且使用寿命极长，在10至15年期间无需翻修。翻修的最常见原因（12个胫骨组件）是胫骨内侧平台出现骨坏死病变，该病变在手术后出现并导致松动。
