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初次全膝关节置换术中带柄胫骨假体的表面骨水泥固定:至少5年随访

Surface cementation of stemmed tibial components in primary total knee arthroplasty: minimum 5-year follow-up.

作者信息

Hofmann Aaron A, Goldberg Tyler D, Tanner Amie M, Cook Thomas M

机构信息

Department of Orthopedics, University of Utah, Salt Lake City, USA.

出版信息

J Arthroplasty. 2006 Apr;21(3):353-7. doi: 10.1016/j.arth.2005.06.012.

Abstract

Cement remains the "gold standard" for fixation in total knee arthroplasty. Between 1991 and 1998, 128 consecutive knees in 109 patients underwent primary cemented total knee arthroplasty using a surface cementation technique. The average follow-up was 95 (range, 63-155) months. Preoperative range of motion (ROM) averaged 5 degrees to 111 degrees which improved to 1 degrees to 116 degrees postoperatively. Modified Hospital for special surgery score (HSS) scores improved from 61 (range, 47-76) to 97 (range, 81-100) and the corresponding Knee Society Scores from 122 (range, 94-152) to 195 (range, 162-200). No osteolytic lesions were found; however, 3 tibias had radiolucent lines which were asymptomatic, nonprogressive, and not associated with implant failure. The average depth of penetration of cement was 2.7 mm. One knee (1%) required revision surgery for femoral loosening, and 1 required revision of the polyethylene liner. The present cementation technique provides excellent durable results at midterm follow-up.

摘要

骨水泥仍然是全膝关节置换术中固定的“金标准”。1991年至1998年期间,109例患者的128个膝关节连续接受了使用表面骨水泥技术的初次骨水泥全膝关节置换术。平均随访时间为95(范围63 - 155)个月。术前活动范围(ROM)平均为5度至111度,术后改善至1度至116度。改良的特殊外科医院评分(HSS)从61(范围47 - 76)提高到97(范围81 - 100),相应的膝关节协会评分从122(范围94 - 152)提高到195(范围162 - 200)。未发现溶骨性病变;然而,3例胫骨有透亮线,无症状、无进展且与植入物失败无关。骨水泥的平均穿透深度为2.7毫米。1个膝关节(1%)因股骨松动需要翻修手术,1个需要翻修聚乙烯衬垫。目前的骨水泥技术在中期随访中提供了出色的持久效果。

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