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用于全膝关节置换术的氧化锆股骨部件:一份对先前报告至少随访10年的说明

Oxidized zirconium femoral component for TKA: a follow-up note of a previous report at a minimum of 10 years.

作者信息

Innocenti Massimo, Matassi Fabrizio, Carulli Christian, Nistri Lorenzo, Civinini Roberto

机构信息

Orthopedic Clinic, Department of Special Surgical Science, University of Florence, CTO-Largo Palagi 1, 50139 Florence, Italy.

Orthopedic Clinic, Department of Special Surgical Science, University of Florence, CTO-Largo Palagi 1, 50139 Florence, Italy.

出版信息

Knee. 2014 Aug;21(4):858-61. doi: 10.1016/j.knee.2014.04.005. Epub 2014 Apr 18.

Abstract

BACKGROUND

New bearing surfaces for total knee replacement have been described in an attempt to reduce polyethylene wear and secondary osteolysis and improve longevity of implants. Oxidized zirconium is a new material that combines the strength of a metal with the wear properties of a ceramic. However, there are no reports as to who documents the long term results. We report a 10 year follow-up note of a selected series of TKAs with an oxidized zirconium femoral component.

METHODS

We prospectively follow 98 TKAs performed in 94 patients with an oxidized zirconium femoral component. Five patients (5 knees) had died and 6 (6 knees) were lost to follow-up at a minimum of 2 years (mean, 6.3 years; range, 2-9 years) after the operation. For the remaining 83 patients (87 knees), the minimum follow-up was 10 years (mean, 11.3 years; range, 10.0-12.6 years). In 51 cases (58.6%), a cruciate-retaining implant with a deep-dished, more conforming PE was used, and in 36 cases (41.4%), a posterior-stabilized design was used. The patellae were resurfaced in 32 cases (36.7%) and in 55 cases (63.3%) were left unresurfaced.

RESULTS

Survivorship was 97.8% at 10 years postoperatively. Two knees were revised for aseptic loosening of the femoral component. No major complication was observed clinically or radiologically. Mean Knee Society score improved from 36 to 84 and functional score from 37 to 83.

CONCLUSIONS

Oxidized zirconium femoral component in TKA performs well over the first 10 years following implantation, with excellent survival rates and good clinical and radiological outcomes.

LEVEL OF EVIDENCE

Level IV, therapeutic study.

摘要

背景

为减少聚乙烯磨损及继发性骨溶解并提高植入物使用寿命,人们已对全膝关节置换的新型承重面进行了描述。氧化锆是一种将金属强度与陶瓷耐磨性能相结合的新型材料。然而,尚无关于长期结果记录的报道。我们报告了一组选用氧化锆股骨组件的全膝关节置换术(TKA)的10年随访记录。

方法

我们前瞻性地随访了94例使用氧化锆股骨组件进行的98例TKA。5例患者(5膝)死亡,6例(6膝)在术后至少2年(平均6.3年;范围2 - 9年)失访。对于其余83例患者(87膝),最短随访时间为10年(平均11.3年;范围10.0 - 12.6年)。51例(58.6%)使用了带有深凹、更贴合聚乙烯的保留交叉韧带植入物,36例(41.4%)使用了后稳定型设计。32例(36.7%)髌骨进行了表面置换,55例(63.3%)未进行表面置换。

结果

术后10年生存率为97.8%。2膝因股骨组件无菌性松动而翻修。临床及影像学均未观察到重大并发症。膝关节协会平均评分从36分提高到84分,功能评分从37分提高到83分。

结论

TKA中氧化锆股骨组件在植入后的前10年表现良好,生存率高,临床及影像学结果良好。

证据级别

IV级,治疗性研究。

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