Eskola A, Vahvanen V, Santavirta S, Honkanen V, Slätis P
Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
J Arthroplasty. 1992 Sep;7(3):223-8. doi: 10.1016/0883-5403(92)90040-w.
During 1984-1986, the authors used the PCA total knee replacement system on 92 knees in 86 patients who were followed for an average of 3.2 years (range, 2.2-4.5 years). Of the 92 knees, 42 were treated due to rheumatoid arthritis (RA) and 50 due to primary or secondary osteoarthrosis (OA). The average age of the patients was 60 years (range, 32-78 years). Seventy-one of the 92 prostheses were inserted without the use of methyl methacrylate cement. Fixation screws for the tibial plate were used in eight cases. One knee was revised due to ligamentous laxity by inserting a thicker tibia plate. Radiographically, there was radiolucency of more than 2 mm below two tibial plates (both RA), and four patellar components (2 RA, 2 OA; 4.3% of total) showed a radiolucent zone of 1 mm or more. Clinically, there were no evident loosenings. According to the Weinfeld scale, 80 knees (37 RA, 43 OA; P = NS) had an excellent result, 10 (6 OA, 4 RA) good, and 2 (1 OA, 1 RA) satisfactory. In comparison, the Hungerford scale gave 47 excellent, 30 good, 14 satisfactory, and 1 poor result. These results reflect that cementless PCA total knee replacement also appears to provide good fixation in both OA and RA knees.
1984年至1986年期间，作者对86例患者的92个膝关节使用了PCA全膝关节置换系统，平均随访3.2年（范围2.2 - 4.5年）。在这92个膝关节中，42个因类风湿性关节炎（RA）接受治疗，50个因原发性或继发性骨关节炎（OA）接受治疗。患者的平均年龄为60岁（范围32 - 78岁）。92个假体中有71个在未使用甲基丙烯酸甲酯骨水泥的情况下植入。8例使用了胫骨平台固定螺钉。1个膝关节因韧带松弛通过插入更厚的胫骨平台进行了翻修。影像学检查显示，两个胫骨平台下方（均为RA）有超过2 mm的透亮区，4个髌骨组件（2例RA，2例OA；占总数的4.3%）显示有1 mm或以上的透亮区。临床上，没有明显的松动。根据温菲尔德量表，80个膝关节（37例RA，43例OA；P =无显著性差异）结果为优，10个（6例OA，4例RA）为良，2个（1例OA，1例RA）为满意。相比之下，亨格福德量表给出的结果为47个优，30个良，14个满意，1个差。这些结果表明，非骨水泥型PCA全膝关节置换在OA和RA膝关节中似乎也能提供良好的固定。
