Bozic Kevin J, Kinder Jeremy, Meneghini R Michael, Zurakowski David, Rosenberg Aaron G, Galante Jorge O
Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94143-0728, USA.
Clin Orthop Relat Res. 2005 Jan(430):117-24. doi: 10.1097/01.blo.0000146539.23869.14.
We evaluated implant survivorship, reoperation rates, and complication rates of a group of patients who had total knee arthroplasty with a third-generation cemented prosthetic device using cruciate-retaining and posterior-stabilized designs at 5 to 8 years followup. Three hundred thirty-four consecutive primary total knee arthroplasties (186 cruciate retaining and 148 posterior stabilized) were done in 287 patients at our institution during a 2-year period. Kaplan Meier survivorship using revision for any reason and revision for aseptic loosening as endpoints were 95.9% and 99.5% respectively at 8 years. Nine patients (four with cruciate-retaining total knee arthroplasties, five with posterior-stabilized total knee arthroplasties; 3.1%) had reoperations for any reason. No patients had reoperation for problems related to the patellofemoral joint. Thirty-two patients (11.1%) had intraoperative or postoperative complications. There were no differences in any of the outcomes analyzed between patients who had cruciate-retaining or posterior-stabilized total knee replacements. Our results show that with appropriate patient selection and meticulous attention to surgical technique, excellent clinical and radiographic results can be achieved with a third-generation total knee arthroplasty system at intermediate followup.
Therapeutic study, Level III-2 (retrospective cohort study).
我们评估了一组接受第三代骨水泥假体全膝关节置换术的患者在5至8年随访期内的植入物存活率、再次手术率和并发症发生率,这些假体采用了保留交叉韧带和后稳定型设计。在我们机构,287例患者在2年期间连续进行了334例初次全膝关节置换术(186例保留交叉韧带,148例后稳定型)。以任何原因翻修和无菌性松动翻修为终点的Kaplan-Meier存活率在8年时分别为95.9%和99.5%。9例患者(4例保留交叉韧带全膝关节置换术,5例后稳定型全膝关节置换术;3.1%)因任何原因进行了再次手术。没有患者因髌股关节相关问题进行再次手术。32例患者(11.1%)出现术中或术后并发症。保留交叉韧带或后稳定型全膝关节置换术患者在分析的任何结果方面均无差异。我们的结果表明,通过适当的患者选择和对手术技术的细致关注,在中期随访中,第三代全膝关节置换系统可取得优异的临床和影像学结果。
治疗性研究,III-2级(回顾性队列研究)。