Department of Orthopaedics and Center for Clinical Research, Falu General Hospital, Falun, Sweden.
Acta Orthop. 2013 Aug;84(4):398-405. doi: 10.3109/17453674.2013.799418. Epub 2013 May 13.
Clinical results of total knee replacement (TKR) are inferior in younger patients, mainly due to aseptic loosening. Coating of components with trabecular metal (TM) is a new way of enhancing fixation to bone. We have previously reported stabilization of TM tibial components at 2 years. We now report the 5-year follow-up of these patients, including RSA of their TM tibial components.
22 patients (26 knees) received an uncemented TM cruciate-retaining tibial component and 19 patients (21 knees) a cemented NexGen Option cruciate-retaining tibial component. Follow-up with RSA, and clinical and radiographic examinations were done at 5 years. In bilaterally operated patients, the statistical analyses included only the first-operated knee.
Both groups had most migration within the first 3 months, the TM implants to a greater extent than the cemented implants. After 3 months, both groups stabilized and remained stable up to the 5-year follow-up.
After a high initial degree of migration, the TM tibia stabilized. This stabilization lasted for at least 5 years, which suggests a good long-term performance regarding fixation. The cemented NexGen CR tibial components showed some migration in the first 3 months and then stabilized up to the 5-year follow-up. This has not been reported previously.
全膝关节置换术(TKR)在年轻患者中的临床效果较差,主要是由于无菌性松动。用小梁金属(TM)对部件进行涂层是增强与骨骼固定的一种新方法。我们之前已经报道了 TM 胫骨部件在 2 年时的稳定情况。现在我们报告这些患者的 5 年随访结果,包括他们的 TM 胫骨部件的 RSA。
22 例(26 膝)患者接受了非骨水泥 TM 交叉韧带保留胫骨部件,19 例(21 膝)患者接受了骨水泥 NexGen Option 交叉韧带保留胫骨部件。在 5 年时进行 RSA、临床和放射学检查。在双侧手术的患者中,统计分析仅包括第一次手术的膝关节。
两组患者在最初的 3 个月内都有最大的迁移,TM 植入物比骨水泥植入物更明显。3 个月后,两组均稳定,直至 5 年随访。
在高初始迁移度后,TM 胫骨稳定下来。这种稳定至少持续了 5 年,这表明固定方面具有良好的长期性能。骨水泥 NexGen CR 胫骨部件在前 3 个月内有一些迁移,然后稳定到 5 年随访。这是以前没有报道过的。