Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, USA.
J Arthroplasty. 2012 Jan;27(1):82-7. doi: 10.1016/j.arth.2011.04.024. Epub 2011 Jul 12.
Revision total knee arthroplasty can be complicated by severe patellar bone loss, precluding the use of standard cemented patellar components. This study evaluated the midterm outcomes of porous tantalum (PT) patellar components. Twenty-three PT components were used in 6 men and 17 women (average age, 62 years). All patellae had less than 10-mm residual thickness. The PT shell was secured to host bone, and a 3-peg polyethylene component was cemented onto the shell. In 2 patients, the PT component was sutured directly to extensor mechanism. Average follow-up was 7.7 years (range, 5-10 years). At follow-up, the Knee Society scores for pain and function averaged 82.7 and 33.3, respectively, whereas the mean Oxford knee score was 32.6. Four patients underwent revision surgery. Survivorship was 19 (83%) of 23 patients. Porous tantalum patellar components can provide fixation where severe bone loss precludes the use of traditional implants. Failures were associated with avascular residual bone and fixation of components to the extensor mechanism.
翻修全膝关节置换术可能会因严重的髌骨骨丢失而变得复杂，从而无法使用标准的骨水泥髌骨组件。本研究评估了多孔钽（PT）髌骨组件的中期结果。在 6 名男性和 17 名女性（平均年龄 62 岁）中使用了 23 个 PT 组件。所有髌骨的残余厚度均小于 10mm。PT 外壳固定在宿主骨上，然后将 3 个销钉聚乙烯组件粘接到外壳上。在 2 名患者中，PT 组件直接缝合到伸肌机制上。平均随访时间为 7.7 年（5-10 年）。随访时，膝关节协会的疼痛和功能评分平均分别为 82.7 和 33.3，而牛津膝关节评分平均为 32.6。4 名患者接受了翻修手术。23 名患者中有 19 名（83%）存活。在严重骨质丢失导致无法使用传统植入物的情况下，多孔钽髌骨组件可以提供固定。失败与无血管性残余骨和组件固定到伸肌机制有关。
