Wu Chia-Chun, Henshaw Robert M, Pritsch Tamir, Squires Malcolm H, Malawer Martin M
Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Arthroplasty. 2008 Sep;23(6):886-93. doi: 10.1016/j.arth.2007.07.007. Epub 2008 Feb 13.
Endoprosthetic reconstruction of the proximal tibia continues to pose many challenges. A retrospective analysis of 44 consecutive patients who underwent cemented proximal tibial replacement were included to investigate if patient age, surgical stage, type of implant, stem diameter, or resection length could be associated with implant failure. Fifteen patients (34%) suffered prosthetic failure, 7 due to infection. Prosthetic-related complications occurred in 13 patients (30%). Custom design prosthesis and longer length of resection were significantly associated with prosthesis survival in a Cox regression analysis (P = .001, hazard ratio = 8.747 and P = .044, hazard ratio = 1.217, respectively). Cemented proximal tibial replacement offers a functional knee, but reducing risk of complications still remains challenging. Prosthetic design and length of resection affect overall cemented endoprosthesis survival.
胫骨近端的人工关节重建仍然面临诸多挑战。本研究纳入了44例连续接受骨水泥型胫骨近端置换术的患者，进行回顾性分析，以探究患者年龄、手术分期、植入物类型、柄直径或截骨长度是否与植入物失败相关。15例患者（34%）出现假体失败，其中7例因感染所致。13例患者（30%）发生了与假体相关的并发症。在Cox回归分析中，定制设计的假体和更长的截骨长度与假体生存率显著相关（P = 0.001，风险比 = 8.747；P = 0.044，风险比 = 1.217）。骨水泥型胫骨近端置换可提供一个功能良好的膝关节，但降低并发症风险仍然具有挑战性。假体设计和截骨长度会影响骨水泥型人工关节的总体生存率。
