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基于社区的植入物登记处中单间室膝关节置换术的分析。

Analysis of unicompartmental knee arthroplasty in a community-based implant registry.

作者信息

Gioe Terence J, Killeen Kathleen K, Hoeffel Daniel P, Bert Jack M, Comfort Thomas K, Scheltema Karen, Mehle Susan, Grimm Katherine

机构信息

St Anthony Orthopaedic Specialists, St. Paul, MN 55102, USA.

出版信息

Clin Orthop Relat Res. 2003 Nov(416):111-9. doi: 10.1097/01.blo.0000093004.90435.d1.

Abstract

Using a unique community implant and explant registry, long-term survival of unicompartmental knee arthroplasty was examined and compared with total knee arthroplasty (TKA) survival. All patients with unicompartmental knee arthroplasties done since September 1, 1991 were followed up prospectively to January 31, 2002 to assess survival and reason for revision. Five hundred sixteen unicompartmental knee arthroplasties of nine different designs were done by 23 surgeons. During this period, 39 of the 516 unicompartmental knee arthroplasties were revised. The major revision reasons for unicompartmental knee arthroplasties were progression of arthritis in the uninvolved compartments (51.3%), aseptic loosening (25.6%), and PE wear (20.5%). Kaplan-Meier survival analysis with revision as the end point revealed survival of 92.6% (range, 90.0%-95.2%) at 5 years for these unicompartmental knee arthroplasties and 88.6% (range, 85.0%-92.2%) at 10 years, compared with 94.8% (range, 93.5%-96.0%) at 10 years for primary TKAs. This community registry experience may more accurately reflect the results obtained in community practice, with different surgeons, varying indications, and numerous designs. The current study showed that revision of unicompartmental knee arthroplasties is done most commonly for progression of arthritis in the contralateral compartment, and at a higher rate than revision of primary cemented TKA.

摘要

利用一个独特的社区植入物和取出物登记系统,对单髁膝关节置换术的长期生存率进行了研究,并与全膝关节置换术(TKA)的生存率进行了比较。对自1991年9月1日以来接受单髁膝关节置换术的所有患者进行前瞻性随访,直至2002年1月31日,以评估生存率和翻修原因。23名外科医生完成了516例九种不同设计的单髁膝关节置换术。在此期间,516例单髁膝关节置换术中的39例进行了翻修。单髁膝关节置换术的主要翻修原因是未受累关节间室关节炎进展(51.3%)、无菌性松动(25.6%)和聚乙烯磨损(20.5%)。以翻修为终点的Kaplan-Meier生存分析显示,这些单髁膝关节置换术5年生存率为92.6%(范围90.0%-95.2%),10年生存率为88.6%(范围85.0%-92.2%),而初次TKA的10年生存率为94.8%(范围93.5%-96.0%)。这个社区登记系统的经验可能更准确地反映了在社区实践中,由不同外科医生、不同适应证和众多设计所获得的结果。当前研究表明,单髁膝关节置换术最常见的翻修原因是对侧关节间室关节炎进展,且翻修率高于初次骨水泥固定TKA。

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