Emerson Roger H, Hansborough Thomas, Reitman Richard D, Rosenfeldt Wolfgang, Higgins Linda L
Texas Center for Joint Replacement, Plano, 75093-7732, USA.
Clin Orthop Relat Res. 2002 Nov(404):62-70. doi: 10.1097/00003086-200211000-00011.
Two well-matched groups of patients with unicompartmental knee arthroplasties were compared. The first 51 knees were treated with a fixed-bearing knee implant and the second 50 knees were treated with a mobile meniscal-bearing implant. Followup was 7.7 years for the patients with fixed-bearing implants and 6.8 years for patients with mobile-bearing implants. Both groups functioned well clinically. Radiographic analysis with 3-foot standing views taken preoperatively showed both groups had an average varus alignment of -2 degrees. Postoperatively patients with fixed-bearing implants had an average +2.6 degrees alignment and the patients with mobile-bearing implants had +5.5 degrees alignment, which was significantly different. Survivorship analysis based on component loosening and revision showed a 99% survival for the meniscal-bearing implant and 93% survival for the fixed-bearing implant at 11 years. However, the fixed-bearing knee implants failed significantly more often because of tibial component failure, in six of eight knees, at an average of 6.3 years. The mobile-bearing implants showed a trend to fail because of arthritic degeneration in the lateral compartment, at an average of 10 years, although not statistically significant. The mobile-bearing implants had no tibial component failures. These differences may be attributable to implant design or surgical technique.
对两组匹配良好的单髁膝关节置换患者进行了比较。第一组51例膝关节采用固定平台膝关节假体治疗，第二组50例膝关节采用活动半月板平台假体治疗。固定平台假体组患者的随访时间为7.7年，活动平台假体组患者的随访时间为6.8年。两组患者的临床功能均良好。术前站立位3英尺X线片分析显示，两组平均内翻畸形均为-2°。术后，固定平台假体组患者平均对线为+2.6°，活动平台假体组患者平均对线为+5.5°，两者差异有统计学意义。基于假体松动和翻修的生存率分析显示，11年时，半月板平台假体的生存率为99%，固定平台假体的生存率为93%。然而，固定平台膝关节假体因胫骨部件失败导致的失败率明显更高，8例中有6例，平均发生时间为6.3年。活动平台假体有因外侧间室关节炎退变而失败的趋势，平均发生时间为10年，尽管差异无统计学意义。活动平台假体未出现胫骨部件失败。这些差异可能归因于假体设计或手术技术。
