Chalidis Byron E, Sachinis Nick P, Papadopoulos Pericles, Petsatodis Evangelos, Christodoulou Anastasios G, Petsatodis George
1st Orthopaedic Department, Aristotle University of Thessaloniki, G.Papanikolaou Hospital, Exochi, 57010, Thessaloniki, Greece.
J Orthop Sci. 2011 Nov;16(6):726-31. doi: 10.1007/s00776-011-0152-1. Epub 2011 Sep 10.
Long-term results of Genesis I modular total knee system are not well known.
We analyzed data from 345 patients with 393 primary total knee arthroplasties (TKA) using the Genesis I prosthesis. In all cases, the posterior cruciate ligament (PCL) was retained, and the patella was not resurfaced. The minimum follow-up was 10 (range 10-16) years.
Preoperative range of motion improved from 89° preoperatively to 105° at the time of the most recent follow-up (p < 0.001). Mean preoperative Knee Society pain and function scores increased from 29 and 25 points to 91 and 85 points, respectively (p < 0.001). Tibiofemoral angle shifted from 2.40° of varus before to 4.8° of valgus after the operation (p < 0.001). Early postoperative complications occurred in 34 knees (8.6%). Manipulation under general anesthesia was done in six knees (1.5%). Nonprogressive radiolucent lines were seen around the femoral component in 16 knees (4%) and at the tibial bone-cement interface in 101 knees (25%). However, in only five cases (1.3%) was there significant progression leading to implant loosening and revision surgery. Eight more revisions were performed due to infection (three knees), stiffness (three knees), excessive wear and fracture of polyethylene liner (one knee), and instability (one knee). The overall survivorship of knee replacement reached 96.7%.
In the long term (up to 16 years), PCL-retaining Genesis I total knee prosthesis is associated with good functional outcomes and low failure rates.
Genesis I模块化全膝关节系统的长期效果尚不清楚。
我们分析了345例患者393例初次全膝关节置换术（TKA）使用Genesis I假体的数据。所有病例均保留后交叉韧带（PCL），未进行髌骨表面置换。最短随访时间为10年（范围10 - 16年）。
术前活动范围从术前的89°改善至最近一次随访时的105°（p < 0.001）。术前膝关节协会疼痛和功能评分平均分别从29分和25分提高到91分和85分（p < 0.001）。胫股角从术前的内翻2.40°转变为术后的外翻4.8°（p < 0.001）。术后早期并发症发生在34例膝关节（8.6%）。6例膝关节（1.5%）在全身麻醉下进行了手法操作。16例膝关节（4%）在股骨部件周围可见非进行性透光线，101例膝关节（25%）在胫骨骨水泥界面可见。然而，只有5例（1.3%）出现明显进展导致植入物松动和翻修手术。另外8例因感染（3例膝关节）、僵硬（3例膝关节）、聚乙烯衬垫过度磨损和骨折（1例膝关节）以及不稳定（1例膝关节）进行了翻修。膝关节置换的总体生存率达到96.7%。
长期（长达16年）来看，保留PCL的Genesis I全膝关节假体具有良好的功能结果和低失败率。
