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60岁以上患者不进行髌骨置换的非骨水泥型LCS旋转平台膝关节置换术:一项中期临床结果研究。

Cementless LCS rotating-platform knee arthroplasty in patients over 60 years without patella replacement: a mid-term clinical-outcome study.

作者信息

Papachristou George, Plessas Spyros, Sourlas John, Chronopoulos Efstathios, Levidiotis Constantine, Pnevmaticos Spyros

机构信息

2nd Department of Orthopedics, University of Athens, Constantopoulion Hospital, Athens, Greece.

出版信息

Med Sci Monit. 2006 Jun;12(6):CR264-8. Epub 2006 May 29.

Abstract

BACKGROUND

The aim of this prospective paper is to present the results of a cementless LCS rotating-platform artificial knee design without resurfacing of the patella in patients over 60 years of age.

MATERIAL/METHODS: In this prospective series, 234 patients were included with 251 knees. The LCS rotating-platform uncemented design was used in all cases, without replacement of the patella. Thirty-four patients were men and 200 were women. Two hundred three patients were suffering from osteoarthrosis (10 bilateral) and 31 patients (7 bilateral) from rheumatoid arthritis. Seventeen patients had a bilateral procedure. Prophylactic antibiotics and anticoagulants were also instituted to all patients.

RESULTS

Forty-nine patients developed deep vein thrombosis and responded well to the applied conservative treatment. Overall results in the first 251 cementless cases at 2 to 9.8 years' follow-up (average: 5.7 years) were good to excellent in 94.4%, fair in 4.7%, and poor in 0.7%. Radiographs of the knees showed good bonding and no signs of radiolucency. The average clinical and functional Knee Society Ratings were 21.07 points and 30.95 points, respectively, preoperatively and 87.95 points and 78.56 points, respectively, at the final follow-up evaluation.

CONCLUSIONS

With an average follow-up of 5.7 years, uncemented LCS rotating-platform knee joint arthroplasty without replacing the patella in patients over 60 years old was found to perform well, with encouraging clinical and radiological results and a survival rate of 98.1%.

摘要

背景

本前瞻性研究旨在呈现60岁以上患者采用无骨水泥LCS旋转平台人工膝关节设计且不进行髌骨表面置换的结果。

材料/方法:在这个前瞻性系列研究中,纳入了234例患者的251个膝关节。所有病例均采用无骨水泥LCS旋转平台设计,未进行髌骨置换。34例为男性,200例为女性。203例患者患有骨关节炎(10例双侧患病),31例患者(7例双侧患病)患有类风湿关节炎。17例患者接受了双侧手术。所有患者均使用了预防性抗生素和抗凝剂。

结果

49例患者发生了深静脉血栓形成,对所采用的保守治疗反应良好。在对最初251例无骨水泥病例进行2至9.8年的随访(平均5.7年)中,总体结果为优的占94.4%,良的占4.7%,差的占0.7%。膝关节X线片显示骨结合良好,无透亮线迹象。术前膝关节协会临床和功能评分平均分别为21.07分和30.95分,最终随访评估时分别为87.95分和78.56分。

结论

平均随访5.7年发现,60岁以上患者采用不置换髌骨的无骨水泥LCS旋转平台膝关节置换术效果良好,临床和影像学结果令人鼓舞,生存率为98.1%。

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