Meneghini R Michael, Hanssen Arlen D
University of Connecticut Health Center, New England Musculoskeletal Institute, Farmington, Conn, USA.
J Knee Surg. 2008 Oct;21(4):307-14. doi: 10.1055/s-0030-1247837.
Cementless fixation in total knee arthroplasty (TKA) has had limited use in recent decades due to past failures in the early generation of cementless designs. Screw track osteolysis, poor polyethylene, and metal-backed patellar component failures contributed to a controversial track record and created a reluctance to embrace cementless fixation in TKA; however, these failure mechanisms are correctable. In addition, there is renewed interest in cementless fixation due to the recent development of improved biomaterials, particularly highly porous metals and highly crosslinked polyethylene, as well as time-saving advantages and long-term osseointegration of cementless fixation. There are long-term reports of successful designs of cementless knee arthroplasty that are nearly equal to the results of cemented designs. This article discusses the past history, current long-term results, and future of cementless fixation in TKA.
近几十年来，由于早期非骨水泥设计的失败，全膝关节置换术（TKA）中的非骨水泥固定应用有限。螺钉道骨质溶解、劣质聚乙烯以及金属背衬髌骨组件的失败导致了有争议的记录，并使得人们不愿在TKA中采用非骨水泥固定；然而，这些失败机制是可以纠正的。此外，由于改进的生物材料的最新发展，特别是高度多孔金属和高度交联聚乙烯，以及非骨水泥固定的省时优势和长期骨整合，人们对非骨水泥固定重新产生了兴趣。有长期报告称，非骨水泥膝关节置换术的成功设计结果几乎与骨水泥设计的结果相当。本文讨论了TKA中非骨水泥固定的过去历史、当前长期结果和未来发展。
