Cameron H U, Jung Y B
Department of Surgery, University of Toronto, Ont.
Can J Surg. 1990 Feb;33(1):53-7.
Twenty-seven hinged (Guepar II) knee replacements were performed on 26 patients with a follow-up of 1 to 7 years (mean 3 years). Indications for the procedure were bone loss (nine cases) nonunion of tibial or femoral fractures (four), anteroposterior instability (five), mediolateral instability (eight) and recurvatum instability (one). Results were good or excellent in 66.6%. Two patients required revision and there were three other implant-related complications. All press-fit stems were radiolucent to some extent and some radiolucency was present close to the knee in all revisions of stem components. No radiolucency was present in revisions of non-stem cemented components. Although the introduction of variable stem length, semi-constrained knees has reduced the need for implants such as the Guepar II prosthesis, the results, especially in terms of radiolucency, are surprisingly good. The authors conclude that a hinged knee remains of value in desperate situations.
对26例患者进行了27次铰链式（Guepar II型）膝关节置换手术，随访时间为1至7年（平均3年）。手术指征包括骨缺损（9例）、胫股骨折不愈合（4例）、前后向不稳定（5例）、内外侧不稳定（8例）和膝反屈不稳定（1例）。66.6%的结果为良好或优秀。2例患者需要翻修，还有3例其他与植入物相关的并发症。所有压配柄在某种程度上均呈放射性透光影，在柄部件的所有翻修病例中，膝关节附近均存在一些放射性透光影。非柄骨水泥固定部件的翻修中未出现放射性透光影。尽管可变柄长度、半限制性膝关节的引入减少了对诸如Guepar II型假体等植入物的需求，但其结果，尤其是在放射性透光影方面，出奇地好。作者得出结论，铰链式膝关节在极端情况下仍有价值。
