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采用米勒-加兰特假体的内侧单髁膝关节置换术。

Medial unicompartmental knee arthroplasty with the Miller-Galante prosthesis.

作者信息

Naudie Douglas, Guerin Jeff, Parker David A, Bourne Robert B, Rorabeck Cecil H

机构信息

Division of Orthopaedic Surgery, London Health Sciences Centre--University Campus, University of Western Ontario, 339 Windermere Road, London, Ontario, Canada N6A 5A5.

出版信息

J Bone Joint Surg Am. 2004 Sep;86(9):1931-5. doi: 10.2106/00004623-200409000-00011.

Abstract

BACKGROUND

Unicompartmental knee arthroplasty has become a popular treatment alternative for osteoarthritis that is confined to the medial part of the knee. Excellent intermediate-term results recently have been reported in association with the Miller-Galante unicompartmental implant. The purpose of the present study was to report on our longer-term experience with the Miller-Galante medial unicompartmental knee implant.

METHODS

We evaluated the results of 113 medial unicompartmental knee arthroplasties that had been performed with use of the Miller-Galante implant in eighty-four patients between 1989 and 2000. The mean age of the patients at the time of surgery was sixty-eight years. Forty-five patients were men, and thirty-nine were women. Thirteen patients (sixteen knees) died at a mean of seven years after the index arthroplasty. No patient was lost to follow-up. The remaining seventy-one patients (ninety-seven knees) were followed for a mean of ten years and were evaluated with use of the Knee Society clinical and radiographic rating system.

RESULTS

Eleven knees were revised at a mean of four years after the index procedure. The mean Knee Society knee and function scores for the sixty-one patients (eighty-six knees) who were living and who had not had a revision improved from 48 and 53 points preoperatively to 93 and 80 points at the time of the most recent evaluation. The five and ten-year rates of survival were 94% and 90%, respectively, with revision to tricompartmental knee arthroplasty as the end point and 93% and 86%, respectively, with revision or radiographic loosening as the end point.

CONCLUSIONS

The Miller-Galante medial unicompartmental knee arthroplasty provided excellent pain relief and restoration of function in carefully selected patients and demonstrated durable implant survival at ten years.

摘要

背景

单髁膝关节置换术已成为治疗局限于膝关节内侧部分骨关节炎的一种流行的替代治疗方法。最近有报道称,Miller-Galante单髁植入物具有出色的中期效果。本研究的目的是报告我们使用Miller-Galante内侧单髁膝关节植入物的长期经验。

方法

我们评估了1989年至2000年间84例患者使用Miller-Galante植入物进行的113例内侧单髁膝关节置换术的结果。手术时患者的平均年龄为68岁。45例为男性,39例为女性。13例患者(16个膝关节)在初次置换术后平均7年死亡。无患者失访。其余71例患者(97个膝关节)平均随访10年,并使用膝关节协会临床和放射学评分系统进行评估。

结果

11个膝关节在初次手术后平均4年进行了翻修。61例存活且未进行翻修的患者(86个膝关节)的膝关节协会膝关节和功能平均评分从术前的48分和53分提高到最近一次评估时的93分和80分。以转为全髁膝关节置换术为终点,5年和10年生存率分别为94%和90%;以翻修或影像学松动为终点,5年和10年生存率分别为93%和86%。

结论

Miller-Galante内侧单髁膝关节置换术在精心挑选的患者中提供了出色的疼痛缓解和功能恢复,并在10年时显示出持久的植入物存活率。

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