Salzer M, Knahr K, Schmidt W, Wurm E
Allgemeinorthopädische Abteilung, Orthopädisches Krankenhaus Wien-Gersthof.
Z Orthop Ihre Grenzgeb. 1991 May-Jun;129(3):230-9. doi: 10.1055/s-2008-1040188.
A total of 54 PCA knee-joint endoprostheses were followed up over a period of 5-8 years. All the uncemented implants (52 femoral components, 52 patellar components, 54 tibial components) were subjected to radiological analysis of the anchorage zone between prosthesis and bone. The results were evaluated on the basis of the postoperative radiographs and the follow-up radiographs, which were divided into four groups. It was necessary to create a 5th group for radiographs not suitable for evaluation. The use of fluoroscopy is therefore essential in order to ensure that all radiographs can be evaluated. The best results were obtained with the uncemented femoral prosthesis. Complete "incorporation" with close contact between prosthesis and bone was observed in all cases, even if implantation was not optimal. Radiological loosening of the uncemented patella occurred in 3 patients, and it was necessary to perform one patellectomy 6 years postoperatively. In the case of the tibia implant, the follow-up showed radiological "incorporation" of the prosthesis in all cases with technically adequate implantation: the tibia implant was inadequately implanted in 8 cases. Radiological loosening of the tibia implant was observed in 4 of these 8 patients. There was a higher rate of radiological failure in the group of patients over 70 years of age, and among patients whose primary disease was primary chronic polyarthritis. However, given technically exact implantation, satisfactory results could be obtained even in these two groups. Clinical pains occurred only several years after evidence of radiological loosening. Radiological follow-up analysis therefore offers a means of obtaining early information about the prosthesis-bone interface of uncemented total knee-joint endoprosthesis.
共对54个PCA膝关节假体进行了5至8年的随访。所有非骨水泥型植入物（52个股骨部件、52个髌骨部件、54个胫骨部件）均接受了假体与骨之间锚固区域的放射学分析。根据术后X线片和随访X线片进行结果评估，这些X线片被分为四组。有必要为不适合评估的X线片设立第五组。因此，为确保所有X线片都能得到评估，荧光透视检查必不可少。非骨水泥型股骨假体取得了最佳效果。在所有病例中均观察到假体与骨之间紧密接触的完全“融合”，即使植入并非最佳状态。3例患者出现非骨水泥型髌骨的放射学松动，术后6年有必要进行1例髌骨切除术。对于胫骨植入物，随访显示在技术植入得当的所有病例中假体均有放射学“融合”：8例胫骨植入物植入不当。这8例患者中有4例观察到胫骨植入物的放射学松动。70岁以上患者组以及原发性疾病为原发性慢性多关节炎的患者中，放射学失败率较高。然而，即使在这两组患者中，若技术植入精确，也可获得满意结果。临床疼痛仅在出现放射学松动迹象数年后才发生。因此，放射学随访分析提供了一种获取非骨水泥型全膝关节假体假体-骨界面早期信息的方法。
