Pokorný D, Jahoda D, Tomaides J, Vavrík P, Landor I, Sosna A
I.ortopedická klinika 1.LF UK, FN Motol, Praha.
Acta Chir Orthop Traumatol Cech. 2005;72(5):277-81.
The aim of the study was to evaluate our seven-year experience with the anatomic, non-constrained SVL/Beznoska implant for total knee replacement.
A total of 374 cemented total knee replacements, using the SVL/Beznoska implant, were evaluated in 333 patients treated at the First Orthopedic Clinic Charles University in Prague, during a seven-year period. In addition, a patellar replacement was used in five of these patients. Included in the evaluation were also eight non-cemented and hybrid SVL/Beznoska implants used 6 years ago.
The aim of the study was to evaluate the results in terms of implant function. Therefore, the longevity of implants was assessed by Kaplan-Meier's survival analysis. Another criterion was the flexion achieved. To be able to compare our clinical results involving the SVL/Beznoska implant with other, foreign types of implants, the patients were evaluated on the basis of the New Jersey Orthopaedics Hospital Knee Evaluation System.
The Kaplan-Meier's survival score was evaluated. The mean maximum flexion achieved in the patients with SVL implants was 107 degrees . The evaluation by the New Jersey Orthopaedics Hospital Knee Evaluation System showed excellent outcomes in 269 (72 %) patients, good outcomes in 79 (21 %) patients, satisfactory in 19 (5 %) and poor in 7 (2 %) patients. There was no mechanical failure of the implant, such as break of an implant or dislocation of a PE component. Six infected implants and four aseptic loosenings were recorded. Three patients diagnosed with an infected total knee replacement had been treated for rheumatoid arthritis for a long time. One patient was on dialysis for renal insufficiency and one had erysipelas.
The results of our group with the SVL/Beznoska implant were compared with those obtained from the group of 63 patients who underwent total knee arthroplasty with the LCS implant. In these patients, the mean maximum flexion achieved was 105 degrees , and the criteria of the Knee Evaluation System showed excellent outcomes in 81 %, good in 16 % and satisfactory in 3 % of the patients. No unsatisfactory outcome was recorded. Considering the fact that the LCS implant was used only in younger and active patients, the outcomes achieved with the SVL/Beznoska system can be regarded as very good. Of the six patients with infectious complications, three were treated with immunosuppressive therapy for rheumatoid arthritis, one was on dialysis for renal insufficiency and one experienced a flare-up of erysipelas.
The most important outcome of the evaluation of 374 total knee replacements, using the SVL implant carried out at the First Orthopedic Department of the First Faculty of Medicine, Charles University, was the finding of a perfect function of all components in all patients treated. None of the complications occurring in our group was associated with the use of this implant.
本研究旨在评估我们使用解剖型、非限制性SVL/贝兹诺斯卡（SVL/Beznoska）假体进行全膝关节置换的七年经验。
在布拉格查理大学第一骨科诊所接受治疗的333例患者中，共评估了374例使用SVL/贝兹诺斯卡假体的骨水泥型全膝关节置换术。此外，其中5例患者还进行了髌骨置换。评估还包括6年前使用的8例非骨水泥型和混合型SVL/贝兹诺斯卡假体。
本研究旨在评估假体功能方面的结果。因此，通过Kaplan-Meier生存分析评估假体的使用寿命。另一个标准是达到的屈曲度。为了能够将我们使用SVL/贝兹诺斯卡假体的临床结果与其他国外类型的假体进行比较，根据新泽西骨科医院膝关节评估系统对患者进行评估。
评估了Kaplan-Meier生存评分。使用SVL假体的患者平均最大屈曲度为107度。新泽西骨科医院膝关节评估系统的评估显示，269例（72%）患者结果优秀，79例（21%）患者结果良好，19例（5%）患者结果满意，7例（2%）患者结果较差。假体没有出现机械故障，如假体断裂或聚乙烯部件脱位。记录到6例感染性假体和4例无菌性松动。3例诊断为感染性全膝关节置换的患者长期患有类风湿关节炎。1例患者因肾功能不全接受透析，1例患者患有丹毒。
将我们使用SVL/贝兹诺斯卡假体的组的结果与63例接受LCS假体全膝关节置换术的患者组的结果进行了比较。在这些患者中，平均最大屈曲度为105度，膝关节评估系统的标准显示，81%的患者结果优秀，16%的患者结果良好，3%的患者结果满意。没有记录到不满意的结果。考虑到LCS假体仅用于年轻且活跃的患者，SVL/贝兹诺斯卡系统取得的结果可被视为非常好。在6例有感染并发症的患者中，3例因类风湿关节炎接受免疫抑制治疗，1例因肾功能不全接受透析，1例丹毒发作。
在查理大学医学院第一附属医院第一骨科进行的374例使用SVL假体的全膝关节置换术评估中，最重要的结果是发现所有接受治疗患者的所有组件功能完美。我们组中发生的并发症均与该假体的使用无关。
