Stiehl James B, Hamelynck Karel J, Voorhorst Paul E
Columbia St Mary's Hospital, Milwaukee, WI, USA.
Int Orthop. 2006 Jun;30(3):190-9. doi: 10.1007/s00264-005-0053-z. Epub 2006 Mar 18.
We retrospectively reviewed the experience of a large international multi-centre study of primary total knee arthroplasty with mobile bearing design and modifications of the tibial component to allow for bicruciate preservation, posterior cruciate retention, or sacrifice. Twenty-seven surgeons performed 4,743 total knee replacements between 1981 and 1997. Implants inserted were 324 that retained both cruciate ligaments, 2,165 that retained the posterior cruciate, and 2,254 that sacrificed both cruciates. The patella was resurfaced in 2,838 and unresurfaced in 1,905. With failure defined as revision or reoperation for any reason, the overall survivorship was 79% at 16 years' follow-up. Revision occurred in 259 (5.4%) knees out of the entire cohort. The risk adjusted rates of failure were higher in females, younger patients, osteoarthritis, post-traumatic arthritis, and in patients who had a meniscal bearing prosthesis or patellar resurfacing. The most common cause of revision was bearing-related issues including chronic instability, bearing subluxation, bearing dislocation, or bearing wear in 2.3%.
我们回顾性分析了一项大型国际多中心研究的经验，该研究涉及采用活动平台设计及改良胫骨部件以保留双交叉韧带、保留后交叉韧带或牺牲后交叉韧带的初次全膝关节置换术。1981年至1997年间，27名外科医生共实施了4743例全膝关节置换手术。植入的假体中，保留双交叉韧带的有324例，保留后交叉韧带的有2165例，牺牲双交叉韧带的有2254例。2838例患者进行了髌骨表面置换，1905例未进行髌骨表面置换。将因任何原因进行翻修或再次手术定义为失败，16年随访时总体生存率为79%。整个队列中有259例（5.4%）膝关节进行了翻修。女性、年轻患者、骨关节炎、创伤后关节炎以及使用半月板支撑假体或进行髌骨表面置换的患者，风险调整后的失败率更高。最常见的翻修原因是与假体相关的问题，包括慢性不稳定、假体半脱位、假体脱位或假体磨损，发生率为2.3%。
