Gofton Wade T, Tsigaras Harry, Butler R Allen, Patterson James J, Barrack Robert L, Rorabeck Cecil H
University of Western Ontario, London, Ontario, Canada.
Clin Orthop Relat Res. 2002 Nov(404):158-68.
The number of revision total knee replacements continues to increase annually. To date, much of the literature has focused on the performance of titanium revision systems. The primary aim of the current study was to review the mid term results of a contemporary revision knee system, with alternative design features. Ninety-one consecutive patients having aseptic revision total knee arthroplasty with one, modular all-cobalt chrome stemmed revision knee system using hybrid stem fixation were studied prospectively. Eighty-nine revisions in 84 patients were reviewed at a mean of 5.9 years (range, 4.1-8.6 years). Significant improvements in pain scores (15 +/- 14 to 38 +/- 14), function (40 +/- 24 to 53 +/- 29), range of motion (88 degrees +/- 23 degrees to 98 degrees +/- 18 degrees ), and total Knee Society score (85 +/- 40 to 132 +/- 40) were seen at followup. Five patients had revision surgery, with a Kaplan-Meier survivorship of 93.5% at 8.6 years. Intermediate results support the use of cobalt chrome components and hybrid cement fixation; however, this fixation in combination with high articular constraint requires continued monitoring.
翻修全膝关节置换术的数量每年都在持续增加。迄今为止，大部分文献都聚焦于钛合金翻修系统的性能。本研究的主要目的是回顾一种具有不同设计特点的当代翻修膝关节系统的中期结果。对91例连续接受无菌性翻修全膝关节置换术的患者进行前瞻性研究，这些患者使用了一种模块化全钴铬柄翻修膝关节系统并采用混合柄固定。对84例患者的89次翻修进行了回顾，平均随访时间为5.9年（范围4.1 - 8.6年）。随访时疼痛评分（从15±14降至38±14）、功能（从40±24提高到53±29）、活动范围（从88°±23°增加到98°±18°）以及全膝关节协会评分（从85±40提高到132±40）均有显著改善。5例患者接受了翻修手术，8.6年时的Kaplan - Meier生存率为93.5%。中期结果支持使用钴铬合金部件和混合骨水泥固定；然而，这种固定方式与高关节约束相结合需要持续监测。
