Cloke David J, Khatri Manoj, Pinder Ian M, McCaskie Andrew W, Lingard Elizabeth A
Department of Orthopaedics, Freeman Hospital, High Heaton, Newcastle-upon-Tyne, UK.
Acta Orthop. 2008 Feb;79(1):28-33. doi: 10.1080/17453670710014725.
Our institution began using the Kinemax total knee arthroplasty system in 1988, both with and without cement fixation. We report 10-year survival figures.
Theater records showed that 284 Kinemax total knee arthroplasties had been performed 1988 through 1993. Life-table survival estimates were used to determine the probability of survivorship 10 years after surgery for the total group and by age, sex, diagnosis, and mode of fixation. Median follow-up was 11 (0.8-15) years for unrevised knees in patients who were still alive.
The 10-year cumulative survivorship was higher (93%, 95% CI: 81-97) when both components had been cemented than if either, or both, were uncemented (77%, CI: 67-83; p < 0.001). There was an increased incidence of failure in patients who were less than 60 years of age at the time of surgery (p = 0.004).
The smooth-backed Kinemax knee without cement was found to be associated with a high failure rate at 10 years. The 10-year cumulative survival results of the cemented prosthesis are acceptable.
我们机构自1988年起开始使用Kinemax全膝关节置换系统，采用骨水泥固定和非骨水泥固定两种方式。我们报告了10年的生存率数据。
手术记录显示，1988年至1993年间共进行了284例Kinemax全膝关节置换术。采用寿命表生存估计法来确定整个组以及按年龄、性别、诊断和固定方式划分的亚组术后10年的生存概率。对仍存活患者中未翻修膝关节的中位随访时间为11（0.8 - 15）年。
当两个组件均采用骨水泥固定时，10年累积生存率更高（93%，95%置信区间：81 - 97），而当其中一个或两个组件未采用骨水泥固定时，生存率为77%（置信区间：67 - 83；p < 0.001）。手术时年龄小于60岁的患者失败发生率增加（p = 0.004）。
发现非骨水泥固定的光滑背Kinemax膝关节在10年时失败率较高。骨水泥固定假体的10年累积生存结果是可以接受的。
