Jensen Claus L, Petersen Michael M, Jensen Karl E, Therbo Matthias, Schrøder Henrik M
Department of Orthopedics U, Rigshospitalet, National University Hospital, Copenhagen, Denmark.
Acta Orthop. 2006 Dec;77(6):917-20. doi: 10.1080/17453670610013222.
The outcome of performing isolated tibial polyethylene insert exchange (ITPIE) after total knee arthroplasty (TKA) is under debate. We evaluated the survival probability of ITPE after uncemented TKA.
27 patients (27 knees) with an ITPIE performed mean 9 (0.9-17) years after the initial TKA were included in the study (22 patients also had the patellar component replaced simultaneously). All patients had their exchange performed at our department between 1997 and 2001 and had their latest follow-up examination mean 40 (8-71) months after the exchange.
During the follow-up, 2 patients had total knee revision because of aseptic loosening and 2 patients had isolated patella component exchange (in 1 of the patients, combined with a new ITPIE). Kaplan-Meier survival analysis gave a survival probability of 80% at 34 months of follow-up.
The short-term survival after an ITPIE was similar to that of a total knee revision with exchange of all components. Since the ITPIE is a much smaller operation with fast rehabilitation, we recommend it in elderly patients with a well-fixed and wellaligned prosthesis without surface damage of the components.
全膝关节置换术（TKA）后进行单纯胫骨聚乙烯衬垫置换（ITPIE）的结果存在争议。我们评估了非骨水泥型TKA后ITPE的生存概率。
本研究纳入了27例患者（27膝），他们在初次TKA后平均9（0.9 - 17）年进行了ITPIE（22例患者同时还进行了髌骨部件置换）。所有患者于1997年至2001年间在我科进行了置换，并在置换后平均40（8 - 71）个月进行了最新的随访检查。
随访期间，2例患者因无菌性松动进行了全膝关节翻修，2例患者进行了单纯髌骨部件置换（其中1例患者同时进行了新的ITPIE）。Kaplan-Meier生存分析显示，随访34个月时的生存概率为80%。
ITPIE后的短期生存率与全膝关节翻修并更换所有部件的生存率相似。由于ITPIE手术规模小得多且康复快，我们建议在假体固定良好、对线良好且部件无表面损伤的老年患者中采用该手术。
