Department of Orthopaedics and Traumatology, University of Turin Medical School, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy.
Knee Surg Sports Traumatol Arthrosc. 2010 Oct;18(10):1360-5. doi: 10.1007/s00167-010-1177-2. Epub 2010 Jun 10.
Controversy still exists regarding which cementation technique of the tibial component is preferable. Full cementation showed excellent long-term outcomes, and surface cementation with fixed-bearing designs provided excellent mid-term results. Concerns have been expressed about possible rotary forces to the tibial rotating platform, when the tibial stem remains cementless, with the risk of early loosening. The purpose of this study was to evaluate the rate of early loosening and radiolucency lines in 70 consecutive unidirectional rotating platform, posterior stabilized, total knee arthroplasties, using surface cementation. Multivariate analysis was performed to identify any correlations between early loosening or radiolucency lines and clinically relevant covariates: age, sex, BMI, follow-up time, cement penetration, radiolucencies, tibial slope, femoral flexion, frontal alignment, pre-operative and post-operative Knee Scores. The tibial plateau was divided into four zones in antero-posterior view and into two zones in lateral view, and the cement penetration was evaluated in each zone. The mean follow-up was 43 months (SD 14), and the average patients' age was 73 (SD 7). The Knee Score averaged 91 (SD 8) and the Function score 86 (SD 17) at last follow-up visit. The cement penetration was >2 mm in all zones. No early loosening was detected, but in five asymptomatic patients (7%) radiolucency was noted around the tibial stem. The presence of radiolucent lines was not correlated with any of the covariates. The rate of early loosening and radiolucency lines with mobile tibial tray and surface cementation is comparable to other studies using different cementation techniques or surface cementation combined with fixed platform total knee arthroplasties.
关于胫骨部件的哪种粘结技术更优仍存在争议。全粘结显示出优异的长期结果，而带固定轴承设计的表面粘结在中期结果中表现出色。人们担心当胫骨柄保持非粘结状态时，胫骨旋转平台可能会受到旋转力的影响，从而增加早期松动的风险。本研究旨在评估 70 例连续单向旋转平台、后稳定型全膝关节置换术使用表面粘结的早期松动和射线不透明线的发生率。采用多变量分析来确定早期松动或射线不透明线与临床相关的协变量之间的任何相关性：年龄、性别、BMI、随访时间、粘结渗透、射线不透明、胫骨倾斜度、股骨弯曲度、额状面排列、术前和术后膝关节评分。在前后视图中，胫骨平台分为四个区，在侧视图中分为两个区，并评估每个区的粘结渗透情况。平均随访时间为 43 个月（SD 14），平均患者年龄为 73 岁（SD 7）。最后一次随访时，膝关节评分为 91（SD 8），功能评分为 86（SD 17）。所有区域的粘结渗透均大于 2mm。未发现早期松动，但在 5 名无症状患者（7%）中，胫骨柄周围出现射线不透明。射线不透明线的存在与任何协变量均无关。使用活动胫骨托盘和表面粘结的早期松动和射线不透明线的发生率与使用不同粘结技术或表面粘结结合固定平台全膝关节置换术的其他研究相当。
