Elwood Justin J, Callaghan John J, Liu Steve S, Goetz Devon D
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
Orthopedics. 2012 Dec;35(12):e1699-704. doi: 10.3928/01477447-20121120-12.
Rotating-platform, mobile-bearing total knee arthroplasty was initially developed using a posterior cruciate-sacrificing technique and design. Posterior cruciate-substituting and -retaining, rotating-platform total knee arthroplasty designs were developed later. The purpose of this study was to evaluate a minimum 4-year follow-up of total knee arthroplasty performed with a posterior cruciate-retaining, rotating-platform design.The 4- to 6-year results of 123 patients undergoing 152 consecutive total knee arthroplasties using a posterior cruciate-retaining, rotating-platform design were evaluated. Patients were evaluated clinically for need for revision, and clinical outcome measures included the pain and functional components of the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form 36 Health Survey, and the University of California Los Angeles activity-level scores. Radiographs were evaluated for loosening, component positioning changes, femoral-tibial alignment, and osteolysis. One knee was lost to follow-up at an average of 5.2 years. No tibial or femoral components required revision. Three polyethylene liners were revised: 2 for infection and 1 for bearing spinout. Average range of motion was 120° (range, 70°-135°). Minor areas of osteolysis were noted around 4.5% of knees, and minimal incomplete radiolucencies were noted around 50% of components. The posterior cruciate-retaining, rotating-platform knee prosthesis demonstrated excellent survivorship at 4- to 6-year follow-up.
旋转平台、活动轴承全膝关节置换术最初是采用后交叉韧带牺牲技术和设计发展而来的。后交叉韧带替代和保留型旋转平台全膝关节置换术的设计随后得以开发。本研究的目的是评估采用后交叉韧带保留型旋转平台设计进行全膝关节置换术后至少4年的随访情况。
对123例患者连续进行的152例采用后交叉韧带保留型旋转平台设计的全膝关节置换术的4至6年结果进行了评估。对患者进行临床评估以确定是否需要翻修，临床结果指标包括膝关节协会评分的疼痛和功能部分、西安大略和麦克马斯特大学骨关节炎指数、简短健康调查问卷36项以及加利福尼亚大学洛杉矶分校活动水平评分。对X线片进行评估，以观察假体松动、组件位置变化、股胫对线和骨溶解情况。平均随访5.2年时，有1例膝关节失访。没有胫骨或股骨组件需要翻修。有3个聚乙烯衬垫进行了翻修：2个因感染，1个因轴承脱出。平均活动范围为120°（范围为70°至135°）。约4.5%的膝关节周围发现了小面积骨溶解，约50%的组件周围发现了最小程度的不完全透亮区。后交叉韧带保留型旋转平台膝关节假体在4至6年随访时显示出优异的生存率。
