Kaiser Permanente, 280 West MacArthur Blvd, Oakland, California 94611, USA.
Bone Joint J. 2013 Mar;95-B(3):367-70. doi: 10.1302/0301-620X.95B3.27585.
We evaluated the impact of pre-coating the tibial component with polymethylmethacrylate (PMMA) on implant survival in a cohort of 16 548 primary NexGen total knee replacements (TKRs) in 14 113 patients. In 13 835 TKRs a pre-coated tray was used while in 2713 TKRs the non-pre-coated version of the same tray was used. All the TKRs were performed between 2001 and 2009 and were cemented. TKRs implanted with a pre-coated tibial component had a lower cumulative survival than those with a non-pre-coated tibial component (p = 0.01). After adjusting for diagnosis, age, gender, body mass index, American Society of Anesthesiologists grade, femoral coupling design, surgeon volume and hospital volume, pre-coating was an independent risk factor for all-cause aseptic revision (hazard ratio 2.75, p = 0.006). Revision for aseptic loosening was uncommon for both pre-coated and non-pre-coated trays (rates of 0.12% and 0%, respectively). Pre-coating with PMMA does not appear to be protective of revision for this tibial tray design at short-term follow-up.
我们评估了在 14113 例患者的 16548 例初次 NexGen 全膝关节置换术（TKR）中，对胫骨组件进行聚甲基丙烯酸甲酯（PMMA）预涂覆对植入物存活率的影响。在 13835 例 TKR 中使用了预涂覆托盘，而在 2713 例 TKR 中使用了相同托盘的非预涂覆版本。所有 TKR 均于 2001 年至 2009 年间进行，并采用了水泥固定。与非预涂覆胫骨组件的 TKR 相比，预涂覆胫骨组件的 TKR 具有较低的累积存活率（p = 0.01）。在调整诊断、年龄、性别、体重指数、美国麻醉医师协会分级、股骨连接设计、外科医生手术量和医院手术量后，预涂覆是全因无菌性翻修的独立危险因素（风险比 2.75，p = 0.006）。预涂覆和非预涂覆托盘的无菌性松动翻修均不常见（分别为 0.12%和 0%）。在短期随访中，PMMA 预涂覆似乎并不能保护这种胫骨托盘设计的翻修。
