North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia.
J Bone Joint Surg Am. 2011 Apr 6;93(7):624-30. doi: 10.2106/JBJS.I.01753.
In vitro analysis has shown that oxidized zirconium on ultra-high molecular weight polyethylene has better wear properties than cobalt-chromium on ultra-high molecular weight polyethylene. The purpose of this study was to determine if oxidized zirconium femoral components performed better than cobalt-chromium in vivo and if the use of oxidized zirconium components had clinical adverse effects.
Forty consecutive patients (eighty knees) underwent simultaneous bilateral cruciate-retaining total knee arthroplasty for primary osteoarthritis from January 2002 to December 2003. For each patient, the knees were randomized to receive the oxidized zirconium femoral component, with the contralateral knee receiving the cobalt-chromium component. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, Knee Society score, and British Orthopaedic Association patient satisfaction scale. Radiographic outcomes include the Knee Society total knee arthroplasty roentgenographic evaluation and scoring system and measurement of radiographic wear. Patients and assessors were blinded to the treatment groups and results.
There were no significant differences in clinical, subjective, and radiographic outcomes between the two implants at five days, six weeks, and one, two, or five years postoperatively. At five years following surgery, 38% of the patients preferred the cobalt-chromium knee compared with 18% who preferred the oxidized zirconium knee (p = 0.02) and 44% had no preference.
Five-year outcomes after total knee arthroplasty with oxidized zirconium and cobalt-chromium femoral components showed no significant differences in clinical, subjective, and radiographic outcomes. Patients had no preference or preferred the cobalt-chromium prosthesis to the oxidized zirconium prosthesis at the time of the five-year follow-up. There were no adverse effects associated with the use of oxidized zirconium femoral implants.
体外分析表明，超高分子量聚乙烯上的氧化锆比超高分子量聚乙烯上的钴铬具有更好的耐磨性能。本研究旨在确定氧化锆股骨部件在体内是否比钴铬表现更好，以及使用氧化锆部件是否有临床不良影响。
40 例连续患者（80 膝）于 2002 年 1 月至 2003 年 12 月因原发性骨关节炎行同期双侧保留交叉韧带全膝关节置换术。每位患者的膝关节随机接受氧化锆股骨部件，对侧膝关节接受钴铬部件。评估结果包括 Western Ontario 和 McMaster 大学骨关节炎指数、膝关节损伤和骨关节炎结果评分、膝关节学会评分以及英国矫形协会患者满意度量表。影像学结果包括膝关节学会全膝关节置换术 X 线评估和评分系统以及 X 线磨损测量。患者和评估者对治疗组和结果均不知情。
术后 5 天、6 周、1 年、2 年和 5 年，两种植入物的临床、主观和影像学结果均无显著差异。术后 5 年，38%的患者更喜欢钴铬膝关节，而 18%的患者更喜欢氧化锆膝关节（p = 0.02），44%的患者没有偏好。
氧化锆和钴铬股骨部件全膝关节置换术后 5 年的结果显示，在临床、主观和影像学结果方面无显著差异。在 5 年随访时，患者对钴铬假体没有偏好或更喜欢氧化锆假体。使用氧化锆股骨植入物没有不良影响。
