Hazelwood Kyle J, O'Rourke Michael, Stamos Van P, McMillan Robert D, Beigler David, Robb William J
Luke Air Force Base, 56th Medical Group, Orthopaedic Surgery, Luke AFB, AZ, United States.
Department of Orthopaedic Surgery, Northshore University Healthsystem, Evanston, IL, United States.
Knee. 2015 Oct;22(5):424-8. doi: 10.1016/j.knee.2015.02.016. Epub 2015 Mar 17.
Early failure in cemented total knee replacement (TKR) due to aseptic loosening is uncommon. A small number of early failures requiring revision were observed at one hospital due to observed cement-implant fixation failure. The purpose of this case series is to report and identify possible causes for these early failures.
Between May 2005 and December 2010, 3048 primary TKRs were performed over a five-year period of time by six surgeons. Two total knee systems were used during this period of time. Nine early failures were observed in eight patients. High viscosity cement (HVC) was used in all these cases.
Aseptic loosening of the tibial component was observed in all nine early total knee failures. The high viscosity bone cement was noted to be non-adherent to the tibial trays at the time of revision surgery. HVC was used in all these cases.
Properties of HVC may contribute to make it more susceptible to early failure in a small number of TKRs. HVC in total hip replacement (THR) has been associated with cement micro-fractures, cement debris generation and early implant failure. The mechanical properties of HVC may similarly contribute to early failure at the cement-implant interface in a small percentage TKRs.
骨水泥型全膝关节置换术（TKR）因无菌性松动导致的早期失败并不常见。在一家医院观察到少数因骨水泥-植入物固定失败而需要翻修的早期失败病例。本病例系列的目的是报告并确定这些早期失败的可能原因。
在2005年5月至2010年12月期间，六位外科医生在五年时间内共进行了3048例初次TKR手术。在此期间使用了两种全膝关节系统。在八名患者中观察到九例早期失败。所有这些病例均使用了高粘度骨水泥（HVC）。
在所有九例早期全膝关节失败病例中均观察到胫骨部件的无菌性松动。在翻修手术时发现高粘度骨水泥与胫骨托不粘连。所有这些病例均使用了HVC。
HVC的特性可能使其在少数TKR中更容易出现早期失败。全髋关节置换术（THR）中的HVC与骨水泥微骨折、骨水泥碎屑产生和早期植入物失败有关。HVC的机械性能可能同样导致一小部分TKR中骨水泥-植入物界面的早期失败。
