Department of Orthopaedic Surgery, National Hospital Organization Shimoshizu Hospital, Chiba, Japan.
J Orthop Surg Res. 2012 Feb 22;7:9. doi: 10.1186/1749-799X-7-9.
Total knee arthroplasty (TKA) is a common form of treatment to relieve pain and improve function in cases of rheumatoid arthritis (RA). Good clinical outcomes have been reported with a variety of TKA prostheses. The cementless Hi-Tech Knee II cruciate-retaining (CR)-type prosthesis, which has 6 fins at the anterior of the femoral component, posterior cruciate ligament (PCL) retention, flat-on-flat surface component geometry, all-polyethylene patella, strong initial fixation by the center screw of the tibial base plate, 10 layers of titanium alloy fiber mesh, and direct compression molded ultra high molecular weight polyethylene (UHMWPE), is appropriate for TKA in the Japanese knee.The present study was performed to evaluate the clinical results of primary TKA in RA using the cementless Hi-Tech Knee II CR-type prosthesis.
We performed 32 consecutive primary TKAs using cementless Hi-Tech Knee II CR-type prosthesis in 31 RA patients. The average follow-up period was 8 years 3 months. Clinical evaluations were performed according to the American Knee Society (KS) system, knee score, function score, radiographic evaluation, and complications.
The mean postoperative maximum flexion angle was 115.6°, and the KS knee score and function score improved to 88 and 70 after surgery, respectively. Complications, such as infection, occurred in 1 patient and revision surgery was performed. There were no cases of loosening in this cohort, and prosthesis survival rate was 96.9% at 12 years postoperatively.
These results suggest that TKA using the cementless Hi-Tech Knee II CR-type prosthesis is a very effective form of treatment in RA patients at 5 to 12 years postoperatively. Further long-term follow-up studies are required to determine the ultimate utility of this type of prosthesis.
全膝关节置换术（TKA）是治疗类风湿关节炎（RA）疼痛和改善功能的常见方法。各种 TKA 假体都有报道取得了良好的临床效果。无水泥 Hi-Tech Knee II 交叉韧带保留型（CR）假体，其股骨部件的前侧有 6 个翼片、保留后交叉韧带（PCL）、平对平表面组件几何形状、全聚乙烯髌骨、由胫骨基板中心螺钉提供的强大初始固定、10 层钛合金纤维网和直接压缩成型超高分子量聚乙烯（UHMWPE），适合日本膝关节的 TKA。本研究旨在评估使用无水泥 Hi-Tech Knee II CR 型假体进行原发性 TKA 在 RA 中的临床效果。
我们对 31 例 RA 患者的 32 例连续原发性 TKA 使用无水泥 Hi-Tech Knee II CR 型假体。平均随访时间为 8 年 3 个月。临床评估根据美国膝关节协会（KS）系统、膝关节评分、功能评分、影像学评估和并发症进行。
术后最大屈曲角度平均为 115.6°，KS 膝关节评分和功能评分分别提高至 88 和 70。发生 1 例感染并发症，行翻修手术。该队列中无假体松动病例，术后 12 年假体存活率为 96.9%。
这些结果表明，在术后 5 至 12 年，使用无水泥 Hi-Tech Knee II CR 型假体的 TKA 是治疗 RA 患者的一种非常有效的方法。需要进一步的长期随访研究来确定这种假体的最终用途。
