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55岁及以下患者膝关节骨性关节炎的骨水泥型全膝关节置换术。

Cemented total knee arthroplasty for gonarthrosis in patients 55 years old or younger.

作者信息

Stern S H, Bowen M K, Insall J N, Scuderi G R

机构信息

Knee Service, Hospital for Special Surgery, New York, NY 10021.

出版信息

Clin Orthop Relat Res. 1990 Nov(260):124-9.

PMID:2225614
Abstract

The results of 68 cemented total knee arthroplasties (TKAs) in 50 patients with gonarthrosis who were 55 years old or younger at the time of surgery were reviewed. These patients were operated on between 1979 and 1987 and were followed for an average of 6.2 years. The average age of the patients was 50 years. Patients were evaluated by the Hospital for Special Surgery knee score. The average preoperative score was 53, and the average follow-up score was 90. Overall, 55 TKAs were rated as excellent and 13 as good. Using the knee rating score advocated by the Knee Society, the average postoperative score was 92 for pain and 84 for function. There were four successful reoperations for patellar component loosening, all in metal-backed patellae. The femoral and tibial components in these patients were intact, and at the follow-up period, two knees were rated as excellent and two as good. Detailed roentgenographic evaluation demonstrated that 20% of tibial components had radiolucencies in at least one zone on the anteroposterior roentgenogram and in 11% on the lateral roentgenogram. Femoral radiolucencies occurred in only 2% of knees. Patellar radiolucencies in one or more zones occurred in 20% of knees that had not had patellar revision. No complete or progressive radiolucencies at the bone-cement interface were noted for any component, and no components were considered to be roentgenographically loose. Cemented TKAs can achieve excellent long-term results in patients younger than 55 years old with gonarthrosis of the knee. These results compare with those obtained in published reports on older age groups.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

回顾了50例膝关节病患者(手术时年龄在55岁及以下)行68例骨水泥型全膝关节置换术(TKA)的结果。这些患者于1979年至1987年间接受手术,平均随访6.2年。患者平均年龄为50岁。采用特殊外科医院膝关节评分对患者进行评估。术前平均评分为53分,随访平均评分为90分。总体而言,55例TKA评定为优,13例为良。采用膝关节协会倡导的膝关节评分标准,术后疼痛平均评分为92分,功能评分为84分。有4例因髌骨部件松动进行的再次手术成功,均为金属背衬髌骨。这些患者的股骨和胫骨部件完好,在随访期,2例膝关节评定为优,2例为良。详细的X线评估显示,20%的胫骨部件在前后位X线片上至少一个区域有透亮线,侧位X线片上为11%。股骨透亮线仅出现在2%的膝关节。未进行髌骨翻修的膝关节中,20%在一个或多个区域出现髌骨透亮线。未发现任何部件在骨水泥界面有完全或进展性透亮线,且无部件在X线片上被认为松动。骨水泥型TKA在55岁以下膝关节病患者中可取得优异的长期效果。这些结果与已发表的关于老年人群的报告结果相当。(摘要截断于250字)

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