Department of Orthopaedic Surgery, Hippokrateion General Hospital, 48 Konstantinoupoleos Street, Thessaloniki 54639, Greece.
J Bone Joint Surg Am. 2011 May 4;93(9):878-84. doi: 10.2106/JBJS.I.01702.
Mobile-bearing knee designs represent an alternative to conventional fixed-bearing implants in total knee arthroplasty. The purpose of this study was to determine the clinical results of a mobile-bearing knee implant.
From 1990 to 1998, 326 primary consecutive mobile-bearing total knee prostheses were implanted in 260 patients who had a mean age and standard deviation of 66.7 ± 6.9 years. Femoral and tibial components were cemented in all knees, and the patella was resurfaced in 199 knees (61%). Patients were evaluated with the use of the Knee Society clinical rating system and radiographic examinations. Complications were noted, and survivorship of the prostheses was determined.
The mean follow-up period was 156 ± 27.3 months, with maximum follow-up at eighteen years. The mean Knee Society knee score improved from 32.4 ± 21.2 preoperatively to 92.6 ± 10.0 at the time of the last follow-up (p = 0.00), and the mean Knee Society functional score improved from 39.3 ± 18.7 preoperatively to 66.7 ± 18.6 at the time of the last follow-up (p = 0.00). Mean knee flexion improved from 92.3° ± 14.5° preoperatively to 112.1° ± 13.4° at the time of the last follow-up (p = 0.00). There were twenty-four (7.4%) knees that required revision. In eighteen (5.5%) knees, worn out or broken polyethylene was found and a polyethylene-only exchange was done. Six knees (1.8%) were fully revised. The survival rate was 0.96 (95% confidence interval, 0.93 to 0.98) at ten years and 0.87 (95% confidence interval, 0.79 to 0.93) at eighteen years.
A fully congruent, mobile-bearing total knee prosthesis had excellent survivorship during the ten to eighteen-year follow-up interval.
在全膝关节置换术中，带活动衬垫的膝关节设计代表了对传统固定衬垫植入物的一种替代选择。本研究的目的是确定一种带活动衬垫的膝关节植入物的临床结果。
1990 年至 1998 年，对 260 例患者的 326 例初次连续的带活动衬垫的全膝关节假体进行了植入，这些患者的平均年龄和标准差为 66.7 ± 6.9 岁。所有膝关节均采用骨水泥固定股骨和胫骨组件，199 例（61%）髌骨进行了表面置换。使用膝关节学会临床评分系统和影像学检查对患者进行评估。记录并发症，并确定假体的存活率。
平均随访时间为 156 ± 27.3 个月，最长随访时间为 18 年。膝关节学会膝关节评分从术前的 32.4 ± 21.2 分提高到最后一次随访时的 92.6 ± 10.0 分（p = 0.00），膝关节学会功能评分从术前的 39.3 ± 18.7 分提高到最后一次随访时的 66.7 ± 18.6 分（p = 0.00）。平均膝关节屈曲度从术前的 92.3° ± 14.5°提高到最后一次随访时的 112.1° ± 13.4°（p = 0.00）。需要翻修的膝关节有 24 例（7.4%）。在 18 例（5.5%）膝关节中，发现磨损或断裂的聚乙烯，仅进行了聚乙烯置换。6 例（1.8%）膝关节进行了全翻修。10 年时的生存率为 0.96（95%置信区间，0.93 至 0.98），18 年时为 0.87（95%置信区间，0.79 至 0.93）。
在 10 至 18 年的随访期间，全关节面、活动衬垫的全膝关节假体具有极好的生存率。
