O'Rourke Michael R, Gardner Jeremy J, Callaghan John J, Liu Steve S, Goetz Devon D, Vittetoe David A, Sullivan Patrick M, Johnston Richard C
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA.
Clin Orthop Relat Res. 2005 Nov;440:27-37. doi: 10.1097/01.blo.0000185451.96987.aa.
We report the results of a minimum 21-year followup of a consecutive series of 103 patients who had 136 Marmor cemented unicompartmental knee replacements done between 1975 and 1982. Patients were evaluated clinically and radiographically. At minimum 21-year followup 14 patients (19 knees) were alive, 87 patients (115 knees) had died, and only two patients (two knees) were lost to followup. The average age at surgery was 70.9 years. The average followup Hospital for Special Surgery knee score was 58. The average Knee Society final followup clinical and functional scores averaged 72 and 53 points, respectively. Nineteen knees (14%) were revised during the 21-year followup period: nine for progression of disease, eight for loosening, and two for pain, at an average of 10.6 years (range, 1-22 years). Of the 19 knees in the 14 patients who were still alive at final followup, seven (37%) were revised: two for tibial loosening, four for disease progression, and one for pain. Unicompartmental knee replacements in this relatively older age group of patients performed well at minimum 21-year followup. Although we are encouraged by these results, only 22% were done in patients who were younger than 65 years at the time of surgery and the results in this group were significantly less durable.
Therapeutic study, Level IV-1 (case series). See the Guidelines for Authors for a complete description of levels of evidence.
我们报告了对1975年至1982年间连续进行136例Marmor骨水泥单髁膝关节置换术的103例患者进行至少21年随访的结果。对患者进行了临床和影像学评估。在至少21年的随访中，14例患者（19个膝关节）存活，87例患者（115个膝关节）死亡，仅有2例患者（2个膝关节）失访。手术时的平均年龄为70.9岁。特殊外科医院膝关节评分的平均随访值为58分。膝关节协会最终随访的临床和功能评分平均分别为72分和53分。在21年的随访期内，19个膝关节（14%）进行了翻修：9个因疾病进展，8个因松动，2个因疼痛，平均翻修时间为10.6年（范围1 - 22年）。在最终随访时仍存活的14例患者的19个膝关节中，7个（37%）进行了翻修：2个因胫骨松动，4个因疾病进展，1个因疼痛。在这个相对年长的患者群体中，单髁膝关节置换术在至少21年的随访中效果良好。尽管我们对这些结果感到鼓舞，但手术时年龄小于65岁的患者仅占22%，且该组的结果耐久性明显较差。
治疗性研究，IV - 1级（病例系列）。有关证据水平的完整描述，请参阅作者指南。
