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后稳定型与保留后交叉韧带的全膝关节置换术

Posterior-stabilized versus posterior cruciate ligament-retaining total knee arthroplasty.

作者信息

Kolisek Frank R, McGrath Michael S, Marker David R, Jessup Nenette, Seyler Thorsten M, Mont Michael A, Lowry Barnes C

机构信息

1OrthoIndy, Indianapolis, IN 46237, USA.

出版信息

Iowa Orthop J. 2009;29:23-7.

Abstract

Posterior-stabilized and posterior cruciate retaining total knee arthroplasty prostheses have had high success rates, but it is unclear whether one design has superior outcomes. The purpose of the present study was to directly compare the outcomes of these two designs. Forty-five patients who received a posterior-stabilized prosthesis were compared to 46 consecutive patients who received a cruciate-retaining implant. At a mean follow-up time of 60 months (range, 49 to 69 months), the mean Knee Society knee scores improved from 42 points (range, 20 to 73 points) to 93 points (range, 39 to 100 points) for the cruciate-retaining group and from 38 points (range, 20 to 70 points) to 94 points (range, 60 to 100 points) for the posterior-stabilized group. The mean Knee Society functional scores improved from 36 points (range, 10 to 60 points) to 71 points (range, 15 to 100 points) for the cruciate-retaining group and from 32 points (range, 10 to 70 points) to 73 points (range, 32 to 100 points) for the posterior-stabilized group. The ranges of motion were 125 degrees (range, 100 to 140 degrees ) and 118 degrees (range, 87 to 135 degrees ) in the cruciate-retaining and posterior-stabilized groups, respectively, at final follow-up. Radiographic analysis revealed no radiolucencies that were progressive or were greater than 1 millimeter in length. There were no re-operations in either group. This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference and existing pathology of the posterior cruciate ligament.

摘要

后稳定型和后交叉韧带保留型全膝关节置换假体的成功率都很高,但尚不清楚这两种设计中哪种的效果更优。本研究的目的是直接比较这两种设计的效果。将45例接受后稳定型假体的患者与46例连续接受交叉韧带保留型植入物的患者进行比较。在平均随访时间60个月(范围49至69个月)时,交叉韧带保留型组的膝关节协会膝关节平均评分从42分(范围20至73分)提高到93分(范围39至100分),后稳定型组从38分(范围20至70分)提高到94分(范围60至100分)。交叉韧带保留型组的膝关节协会功能平均评分从36分(范围10至60分)提高到71分(范围15至100分),后稳定型组从32分(范围10至70分)提高到73分(范围32至100分)。在末次随访时,交叉韧带保留型组和后稳定型组的活动范围分别为125度(范围100至140度)和118度(范围87至

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