Takakura Y, Tanaka Y, Sugimoto K, Tamai S, Masuhara K
Department of Orthopedic Surgery, Nara Medical University, Japan.
Clin Orthop Relat Res. 1990 Mar(252):209-16.
From 1975 to 1980, total ankle arthroplasty was performed using a metal and polyethylene prosthesis on 30 ankles in 28 patients with painful arthritis. However, because loosening and sinking of the prosthesis were significant, a ceramic total prosthesis was designed in 1980 to be used without cement. Between 1980 and 1987, 39 ankles in 35 patients with osteoarthritis, rheumatoid arthritis, and hemophilic arthritis were replaced using the ceramic prosthesis. Out of 39 ankles, nine were replaced with cement and 30 without cement. The follow-up period for the cemented metal and ceramic cases ranged from 13.4 to 6.2 years, with an average of 8.1 years, and for uncemented ceramic cases from 1.2 to 6.4 years, with an average of 4.1 years. Based on a rating scale for ankle evaluation, 27% of the cemented cases and 67% of the uncemented cases are satisfactory. Five metal ankles and one ceramic ankle were reoperated upon, with one revision and five arthrodeses performed. Ceramic total ankle arthroplasty, performed without cement, has to date provided mostly excellent stable results.
1975年至1980年期间，采用金属和聚乙烯假体对28例患疼痛性关节炎患者的30个踝关节进行了全踝关节置换术。然而，由于假体松动和下沉情况严重，1980年设计了一种无需骨水泥的陶瓷全假体。1980年至1987年期间，使用该陶瓷假体对35例患骨关节炎、类风湿性关节炎和血友病性关节炎患者的39个踝关节进行了置换。在这39个踝关节中，9个使用了骨水泥，30个未使用骨水泥。使用骨水泥的金属和陶瓷病例的随访期为6.2至13.4年，平均8.1年，未使用骨水泥的陶瓷病例的随访期为1.2至6.4年，平均4.1年。根据踝关节评估评分标准，使用骨水泥的病例中有27%结果令人满意，未使用骨水泥的病例中有67%结果令人满意。对5个金属踝关节和1个陶瓷踝关节进行了再次手术，其中进行了1次翻修手术和5次关节融合术。迄今为止，未使用骨水泥进行的陶瓷全踝关节置换术大多取得了出色的稳定效果。
