Lombardi Adolph V, Berasi Carl C, Berend Keith R
Joint Implant Surgeons, Inc, New Albany, Ohio 43054, USA
J Arthroplasty. 2007 Jun;22(4 Suppl 1):25-9. doi: 10.1016/j.arth.2007.02.006.
Cementless total knee arthroplasty (TKA) implants were designed as an alternative to cemented implants. They were touted to provide long-term fixation without the fear of cement debris particle generation and cement degradation resulting in late prosthetic loosening and failure. They were envisioned as a superior solution for TKA in younger patients. However, critical studies revealed a unique set of complications, which included poor fixation as evidenced by frequent occurrence of radiolucent lines, aseptic loosening, osteolysis, and patellar polyethylene dissociation from metal-backed cementless patellar components. At the same time, cemented prostheses continue to yield excellent results. To address some of the issues with cementless implants, porous metal devices have been produced. Although in vitro and early in vivo clinical studies show promising results, these devices must be measured against cemented fixation, which continues to be the "gold standard" in TKA.
非骨水泥全膝关节置换术（TKA）植入物被设计为骨水泥植入物的替代方案。它们被吹捧为能提供长期固定，无需担心骨水泥碎屑颗粒的产生以及骨水泥降解导致假体晚期松动和失效。它们被视为年轻患者TKA的更优解决方案。然而，关键研究揭示了一系列独特的并发症，包括经常出现的透亮线、无菌性松动、骨溶解以及金属背衬非骨水泥髌骨组件的髌骨聚乙烯分离所证明的固定不佳。与此同时，骨水泥假体继续产生优异的效果。为了解决非骨水泥植入物的一些问题，已生产出多孔金属装置。尽管体外和早期体内临床研究显示出有前景的结果，但这些装置必须与骨水泥固定进行比较，而骨水泥固定仍是TKA的“金标准”。
