London Sarcoma Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
J Arthroplasty. 2011 Sep;26(6):903-8. doi: 10.1016/j.arth.2010.07.029. Epub 2010 Nov 12.
Knee arthrodesis is most commonly performed for failed total knee arthroplasty. Conventional arthrodesis techniques are associated with a high incidence of complications and are unsuitable in cases with extensive bone loss. We report our medium-term results using a custom-made cemented knee arthrodesis prosthesis in 10 patients with a mean follow-up of 56.4 months (range, 15-199 months). The prosthesis was implanted as a 1- or 2-stage procedure for infected revision knee arthroplasty or tumor endoprosthesis in 9 patients and as a primary procedure in 1 patient with angiosarcoma involving the knee extensor mechanism. The average combined femoral and tibial bone deficit was 170 mm (range, 56-220 mm). Implant survivorship was 90%. All patients with retained prosthesis had no evidence of residual infection or loosening and were able to mobilize independently. One prosthesis was revised though retained following a prosthetic fracture, and 1 patient underwent above-knee amputation for uncontrolled infection. We conclude that the Stanmore knee arthrodesis prosthesis provides reliable fusion in an otherwise difficult-to-treat group of patients.
膝关节融合术最常用于全膝关节置换术失败的情况。传统的关节融合技术并发症发生率高，不适合广泛骨丢失的病例。我们报告了使用定制的水泥膝关节融合假体治疗 10 例患者的中期结果，平均随访 56.4 个月（范围 15-199 个月）。该假体作为 1 期或 2 期手术植入，用于 9 例感染性翻修膝关节置换术或肿瘤假体，1 例患者因累及膝关节伸肌机制的血管肉瘤而行一期手术。平均股骨和胫骨骨缺损为 170 毫米（范围 56-220 毫米）。植入物存活率为 90%。所有保留假体的患者均无残留感染或松动的证据，能够独立活动。1 例假体因假体骨折而翻修，但保留了假体，1 例患者因感染无法控制而行膝上截肢。我们得出结论，斯坦莫尔膝关节融合假体为一组难以治疗的患者提供了可靠的融合。
