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单半径、高屈曲后稳定型全膝关节置换术的至少五年随访结果

Minimum five-year follow-up results of single-radius, high-flex posterior-stabilized TKA.

作者信息

Moon Young-Wan, Seo Jai-Gon, Chang Moon Jong, Yang Jae-Hyuk, Jang Sung-Won

机构信息

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Orthopedics. 2010 Mar;33(3). doi: 10.3928/01477447-20100129-06. Epub 2010 Mar 10.

Abstract

We studied 75 primary total knee arthroplasties (TKAs) performed using a single-radius, high-flex posterior-stabilized insert design with a minimum 5-year follow-up to document its implant specific complications and clinical results. Nonprogressive osteolysis was observed at zone 4 of the femoral component in 6 knees (8%) and at zone 1 of the tibial component in 6 knees (8%). However, no complications associated with high flexion designs, such as early aseptic loosening, were observed.Preoperatively, mean Knee Society Knee Score and Knee Society Function Score were 55.1 and 45.5, respectively (range, 10-83 and 20-80, respectively). At last follow-up, mean Knee Society Knee Score and Knee Society Function Score improved to 94.9 and 85.9, respectively (range, 70-100 [P<.0001] and 45-100 [P<.0001], respectively). Mean maximal flexion was 122.1 degrees (range, 90 degrees -140 degrees ) and mean range of motion (ROM) was 110.3 degrees (range, 80 degrees -135 degrees ) preoperatively, and these values improved to 128.9 degrees (range, 110 degrees -150 degrees [P<.0001]) and 127.8 degrees (range, 110 degrees -150 degrees [P<.0001]), respectively, at last follow-up. Preoperative ROM was found to be the only factor significantly correlated with postoperative ROM at last follow-up by univariate (P=.0020) and multivariate analysis (P<.0067). Accordingly, clinical results were comparable to previous reports of high-flex implants without implant-specific complications.

摘要

我们研究了75例采用单半径、高屈曲后稳定型衬垫设计的初次全膝关节置换术(TKA),并进行了至少5年的随访,以记录其特定植入物并发症和临床结果。在6例(8%)膝关节的股骨部件4区和6例(8%)膝关节的胫骨部件1区观察到非进行性骨溶解。然而,未观察到与高屈曲设计相关的并发症,如早期无菌性松动。术前,膝关节协会膝关节评分和膝关节协会功能评分的平均值分别为55.1和45.5(范围分别为10 - 83和20 - 80)。在最后一次随访时,膝关节协会膝关节评分和膝关节协会功能评分的平均值分别提高到94.9和85.9(范围分别为70 - 100[P <.0001]和45 - 100[P <.0001])。术前平均最大屈曲度为122.1度(范围为90度 - 140度),平均活动范围(ROM)为110.3度(范围为80度 - 135度),在最后一次随访时,这些值分别提高到128.9度(范围为110度 - 150度[P <.0001])和127.8度(范围为110度 - 150度[P <.0001])。单因素分析(P =.0020)和多因素分析(P <.0067)发现,术前ROM是与最后一次随访时术后ROM显著相关的唯一因素。因此,临床结果与先前关于高屈曲植入物的报告相当,且无特定植入物并发症。

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