Suarez Juan, Griffin William, Springer Bryan, Fehring Thomas, Mason J Bohannon, Odum Susan
Veteran's Administration Hospital, San Juan, Puerto Rico.
J Arthroplasty. 2008 Sep;23(6 Suppl 1):99-103. doi: 10.1016/j.arth.2008.04.020. Epub 2008 Jun 5.
This study identified the mechanisms of failure and the variables associated with failure after revision knee arthroplasty. Five hundred sixty-six index revision knee arthroplasties were studied. Of index revisions, 12.0% failed at an average of 40.1 months. Predominant revision failure modes included infection (46%), aseptic loosening (19%), and instability (13%). Only 4.3% of knees revised for aseptic loosening required rerevision as compared to 21% of knees revised for infection. Revision knee arthroplasty was more likely to fail in younger patients and in those who underwent polyethylene exchanges. Mechanisms of failure for revision arthroplasties are different than for primary knee arthroplasties. Revisions for infection are 4 times more likely to fail than revisions for aseptic loosening. The survivorship for the entire cohort, with revision for any reason as an end point, was 82% at 12 years.
本研究确定了翻修膝关节置换术后的失败机制以及与失败相关的变量。对566例初次翻修膝关节置换术进行了研究。在初次翻修中，12.0%的患者平均在40.1个月时出现失败。主要的翻修失败模式包括感染（46%）、无菌性松动（19%）和不稳定（13%）。因无菌性松动进行翻修的膝关节中，只有4.3%需要再次翻修，而因感染进行翻修的膝关节中这一比例为21%。翻修膝关节置换术在年轻患者以及接受聚乙烯置换的患者中更有可能失败。翻修关节成形术的失败机制与初次膝关节置换术不同。因感染进行的翻修比因无菌性松动进行的翻修失败的可能性高4倍。以因任何原因进行翻修为终点，整个队列在12年时的生存率为82%。
