University of Iowa and VA Medical Center, 200 Hawkins Drive, UIHC, 01029 JPP, Iowa City, IA 52242, USA.
J Bone Joint Surg Am. 2010 Jul 7;92(7):1635-9. doi: 10.2106/JBJS.I.01012.
We previously evaluated 119 consecutive total knee arthroplasties performed by a single surgeon in eighty-six patients with use of the cemented LCS (low contact stress) mobile-bearing, rotating-platform system and an all-polyethylene patellar component. The average age of the patients at the time of surgery was seventy years. The patients were contacted as part of their routine follow-up and were asked to participate in this study. The purpose of the present study was to report the updated results at a minimum follow-up of twenty years. Twenty patients (twenty-six knees) were living, and one was lost to follow-up. Three knees required a reoperation (two for periprosthetic fractures and one for infection). No component was revised as a part of the reoperations. No knee required revision since the fifteen-year follow-up evaluation. Osteolysis was present in six knees compared with only three knees at the time of the fifteen-year follow-up. One knee had radiographic signs of femoral component loosening, which was associated with osteolysis. It occurred after the fifteen-year follow-up study. The average range of motion was from 1 degrees of extension to 105 degrees of flexion. The average clinical and functional Knee Society scores were 43 and 49 points, respectively, at the preoperative evaluation and 89 and 67 points at the time of the final follow-up. We concluded that the cemented LCS rotating-platform knee performed well, with durable clinical and radiographic results at a minimum follow-up of twenty years. However, the prevalence of osteolysis continues to increase with a longer duration of follow-up in these patients.
我们之前评估了一位外科医生在 86 名患者中进行的 119 例连续全膝关节置换术,使用的是 LCS(低接触应力)固定的活动平台、旋转平台系统和全聚乙烯髌骨组件。患者在手术时的平均年龄为 70 岁。作为常规随访的一部分,联系了这些患者并邀请他们参加本研究。本研究的目的是报告至少 20 年的随访更新结果。20 名患者(26 个膝关节)存活,1 名失访。3 个膝关节需要再次手术(2 个为假体周围骨折,1 个为感染)。在这些再手术中,没有任何部件需要修改。自 15 年随访评估以来,没有膝关节需要翻修。与 15 年随访时相比,现在有 6 个膝关节出现了骨溶解,而当时只有 3 个膝关节出现了骨溶解。1 个膝关节出现了股骨部件松动的放射学迹象,与骨溶解有关。这发生在 15 年随访研究之后。平均活动范围为 1 度伸展至 105 度屈曲。术前评估的平均临床和功能膝关节协会评分分别为 43 分和 49 分,最后一次随访时分别为 89 分和 67 分。我们得出结论,固定的 LCS 旋转平台膝关节表现良好,在至少 20 年的随访中具有持久的临床和放射学结果。然而,随着这些患者随访时间的延长,骨溶解的发生率继续增加。