Keenan A C M, Wood A M, Arthur C A, Jenkins P J, Brenkel I J, Walmsley P J
Victoria Hospital, Department of Orthopaedics, Kirkcaldy KY2 5AH, UK.
J Bone Joint Surg Br. 2012 Jul;94(7):928-31. doi: 10.1302/0301-620X.94B7.27031.
We report the ten-year survival of a cemented total knee replacement (TKR) in patients aged < 55 years at the time of surgery, and compare the functional outcome with that of patients aged > 55 years. The data were collected prospectively and analysed using Kaplan-Meier survival statistics, with revision for any reason, or death, as the endpoint. A total of 203 patients aged < 55 years were identified. Four had moved out of the area and were excluded, leaving a total of 221 TKRs in 199 patients for analysis (101 men and 98 women, mean age 50.6 years (28 to 55)); 171 patients had osteoarthritis and 28 had inflammatory arthritis. Four patients required revision and four died. The ten-year survival using revision as the endpoint was 98.2% (95% confidence interval 94.6 to 99.4). Based on the Oxford knee scores at five and ten years, the rate of dissatisfaction was 18% and 21%, respectively. This was no worse in the patients aged < 55 years than in patients aged > 55 years. These results demonstrate that the cemented PFC Sigma knee has an excellent survival rate in patients aged < 55 ten years post-operatively, with clinical outcomes similar to those of an older group. We conclude that TKR should not be withheld from patients on the basis of age.
我们报告了手术时年龄小于55岁的患者行骨水泥型全膝关节置换术（TKR）后的十年生存率，并将其功能结果与年龄大于55岁的患者进行比较。数据前瞻性收集，并采用Kaplan-Meier生存统计分析，以任何原因的翻修或死亡作为终点。共确定了203例年龄小于55岁的患者。4例迁出该地区，被排除在外，最终纳入分析的199例患者共221次TKR（101例男性和98例女性，平均年龄50.6岁（28至55岁））；171例患骨关节炎，28例患炎性关节炎。4例需要翻修，4例死亡。以翻修为终点的十年生存率为98.2%（95%置信区间94.6至99.4）。根据五年和十年时的牛津膝关节评分，不满意率分别为18%和21%。年龄小于55岁的患者情况并不比年龄大于55岁的患者差。这些结果表明，骨水泥型PFC Sigma膝关节在术后十年的年龄小于55岁的患者中具有出色的生存率，临床结果与老年组相似。我们得出结论，不应基于年龄而不给患者进行TKR手术。
