Hooper G, Rothwell A, Frampton C
Department of Orthopaedic Surgery, Christchurch Public Hospital, Private Bag, Christchurch, New Zealand.
J Bone Joint Surg Br. 2009 Jan;91(1):58-63. doi: 10.1302/0301-620X.91B1.20484.
We have examined the outcome of 400 consecutive patients who underwent total knee replacement with the Low Contact Stress mobile-bearing system between 1993 and 1994 and were followed up for a minimum of ten years. All operations were performed by surgeons in Christchurch, New Zealand, who used no other knee prosthesis during the study time. At ten years after operation 238 patients (244 knees) remained for independent clinical and radiological assessment. There was a significant improvement (p < 0.001) in the postoperative knee scores at one, three, seven and ten years, although a slight deterioration in the score occurred between seven and ten years which did not reach statistical significance. The survival for polyethylene wear or loosening was 97% (95% CI 96 to 98) and survival using reoperation for any cause was 92% (95% CI 90 to 94) at 12 years. Polyethylene wear was more common in the meniscal-bearing component, with five knees requiring revision and a further eight demonstrating early wear. Osteolysis was not seen in the rotating platform component, but was present in three of the meniscal-bearing knees. There was no association between the radiological alignment at one year and those knees that subsequently required revision. However, there was an association between the overall limb alignment and the Western Ontario McMasters University score (p < 0.001). The Low Contact Stress mobile-bearing total knee replacement has proved to be a reliable implant at ten years when used in primary knee replacement irrespective of the deformity and diagnosis.
我们对1993年至1994年间采用低接触应力活动平台系统接受全膝关节置换术且随访至少十年的400例连续患者的结果进行了研究。所有手术均由新西兰克赖斯特彻奇的外科医生进行，他们在研究期间未使用其他膝关节假体。术后十年，238例患者（244膝）接受了独立的临床和放射学评估。术后1年、3年、7年和10年时膝关节评分有显著改善（p<0.001），尽管7年至10年时评分略有下降，但未达到统计学意义。12年时，聚乙烯磨损或松动的生存率为97%（95%CI 96至98），因任何原因再次手术的生存率为92%（95%CI 90至94）。半月板活动平台部件的聚乙烯磨损更常见，有5膝需要翻修，另有8膝显示早期磨损。旋转平台部件未见骨溶解，但3例半月板活动平台膝存在骨溶解。术后1年的放射学对线与随后需要翻修的膝关节之间无关联。然而，整体肢体对线与西安大略麦克马斯特大学评分之间存在关联（p<0.001）。低接触应力活动平台全膝关节置换术在用于初次膝关节置换时，无论畸形和诊断如何，在十年时已被证明是一种可靠的植入物。
