Fehring Thomas K, Odum Susan, Griffin William L, Mason J Bohannon
OrthoCarolina Hip and Knee Center, Charlotte, NC 28207, USA.
Clin Orthop Relat Res. 2005 Nov;440:131-4. doi: 10.1097/01.blo.0000186560.70566.dc.
We compare the clinical and radiographic results of partial-component versus full-component revision total knee arthroplasty. A retrospective review was used to identify patients who had partial revision total knee arthroplasty. Only isolated femoral or tibial revisions were included. From 1986 to 2000, 448 revision total knee arthroplasties were done. Seventy-seven partial revisions were done. Three were excluded for a diagnosis of infection. The average followup was 63 months. The average Knee Society score for full component revisions was 85 compared with 79 for partial revisions. This difference was significant (p = 0.0001). The average Knee Society score for those patients who had a full revision for instability was 85 compared with 63 for partial revision (p = 0.0001). The average Knee Society score for those patients who had a full revision for wear-related problems was 88 compared with 78 for partial revisions (p = 0.03). Although the advantages of partial revision in hip replacement are well-documented, the efficacy of this treatment strategy has not been established in revision total knee arthroplasty. Care should be taken when considering partial revision for instability or wear-related problems.
Therapeutic study, Level III (retrospective cohort study). See the Guidelines for Authors for a complete description of levels of evidence.
我们比较了部分组件翻修与全组件翻修全膝关节置换术的临床和影像学结果。采用回顾性研究来确定接受部分翻修全膝关节置换术的患者。仅纳入孤立的股骨或胫骨翻修病例。1986年至2000年期间，共进行了448例全膝关节置换翻修手术。其中77例为部分翻修。3例因诊断为感染而被排除。平均随访时间为63个月。全组件翻修的平均膝关节协会评分是85分，而部分翻修的评分为79分。这种差异具有统计学意义（p = 0.0001）。因不稳定进行全翻修的患者平均膝关节协会评分为85分，而部分翻修的评分为63分（p = 0.0001）。因磨损相关问题进行全翻修的患者平均膝关节协会评分为88分，而部分翻修的评分为78分（p = 0.03）。虽然髋关节置换术中部分翻修的优势已有充分记录，但这种治疗策略在全膝关节置换翻修术中的疗效尚未确立。在考虑因不稳定或磨损相关问题进行部分翻修时应谨慎。
治疗性研究，III级（回顾性队列研究）。有关证据水平的完整描述，请参阅作者指南。
