Rosenberg A G, Barden R M, Galante J O
Department of Orthopaedics, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Clin Orthop Relat Res. 1990 Nov(260):71-9.
One hundred thirty-nine cemented and 132 cementless Miller-Galante total knee prostheses were followed between three and six years (average, 43-44 months). The fixation technique was based on patient age, bone quality, and ability to delay full-weight bearing. Clinical follow-up studies were possible on 116 cemented knees. Fifteen knees were lost because of death before the three-year follow-up study, and eight knees required component removal. One hundred twenty-three cementless knees were available for clinical follow-up studies; there were three deaths, and six failures required component removal. No cemented failure was due to fixation, and three cementless failures were due to lack of tibial ingrowth in two and pain of undetermined etiology in one. Preoperative knee scores were slightly significant with cemented knees averaging 48 points and cementless knees averaging 52 points. A similar significant difference was maintained at the final follow-up study. No significant differences were noted for pain, limp, or support scores. Average range of motion was similar in the two groups. Radiolucent lines about the femoral component were rare. Cementless tibial radiolucencies were partial in up to 20% of examined zones, and complete tibial tray radiolucency was seen in only three patients. No correlation between radiolucency and knee scores was seen.
对139例采用骨水泥固定和132例非骨水泥固定的Miller-Galante全膝关节假体进行了3至6年(平均43 - 44个月)的随访。固定技术基于患者年龄、骨质以及延迟完全负重的能力。对116例采用骨水泥固定的膝关节进行了临床随访研究。15例膝关节因在三年随访研究前死亡而失访,8例膝关节需要取出假体组件。123例非骨水泥固定的膝关节可用于临床随访研究;有3例死亡,6例失败需要取出假体组件。骨水泥固定的膝关节无一例因固定失败,非骨水泥固定的膝关节有3例失败,其中2例是由于胫骨骨长入不足,1例是病因不明的疼痛。术前膝关节评分略有差异,骨水泥固定的膝关节平均得分为48分,非骨水泥固定的膝关节平均得分为52分。在最终随访研究中保持了类似的显著差异。在疼痛、跛行或支撑评分方面未发现显著差异。两组的平均活动范围相似。股骨组件周围的透亮线很少见。非骨水泥固定的胫骨透亮区在高达20%的检查区域为部分透亮,仅3例患者出现胫骨托完全透亮。未发现透亮线与膝关节评分之间存在相关性。