Orthopaedic Department, General Hospital of Patras, Tsertidou 1, 26335, Patras, Greece.
AMR Advanced Medical Research, Hofenstrasse 89b, 8708, Männedorf, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2017 Sep;25(9):2801-2808. doi: 10.1007/s00167-015-3769-3. Epub 2015 Sep 3.
While cemented total knee arthroplasty (TKA) is currently the gold standard for primary osteoarthritis, cementless component fixation has achieved increasingly comparable outcomes due to improvements in both implant designs and surgical technique. Long-term outcomes and survivorship with the TC-Plus cementless, titanium plasma-coated TKA system without patella resurfacing were evaluated.
A homogenous population of 171 consecutive patients who received 206 primary TC-Plus TKAs without patella resurfacing over a 19-year period was retrospectively reviewed. Knee Society Clinical Rating System (KSCRS) scores were obtained, and radiographic evaluation was performed after a mean follow-up of 13.2 ± 8.4 years. Survivorship analysis was made with endpoints revision for any reason and aseptic loss of biological fixation.
One hundred and thirty-six TKAs implanted in 113 patients were available for analysis. Mean KSCRS clinical and functional scores improved significantly versus preoperative values. No radiological loss of biological fixation of femoral and tibial components was observed. Survival with aseptic revision of any component as the endpoint was 95.7 % (95 % confidence interval (CI) 91.7-97.9 %) and 93.6 % (95 % CI 87.8-96.6 %) at 10 and 15 years, respectively.
Titanium plasma-coated cementless TKA without patella resurfacing showed excellent long-term results, with high 10- and 15-year component survival rates. The clinical and radiological results were comparable to those of other cementless TKAs, providing further evidence for the non-cemented resurfacing of the osteoarthritic knee.
IV.
虽然骨水泥固定全膝关节置换术（TKA）目前是原发性骨关节炎的金标准，但由于植入物设计和手术技术的改进，非骨水泥组件固定已取得越来越可比的结果。本文评估了 TC-Plus 非骨水泥、钛等离子涂层 TKA 系统在不进行髌骨表面置换的情况下的长期结果和存活率。
回顾性分析了 19 年内连续 171 例接受 206 例 TC-Plus 初次 TKA 治疗且不进行髌骨表面置换的患者。获得膝关节学会临床评分系统（KSCRS）评分，并在平均 13.2±8.4 年的随访后进行放射学评估。采用任何原因翻修和生物固定无菌丢失作为终点进行生存分析。
113 例患者中的 136 例 TKA 可用于分析。平均 KSCRS 临床和功能评分与术前相比显著提高。未观察到股骨和胫骨组件的生物固定出现放射学丢失。以任何组件无菌翻修为终点的生存率为 95.7%（95%置信区间[CI]91.7-97.9%）和 93.6%（95%CI 87.8-96.6%），分别在 10 年和 15 年时。
不进行髌骨表面置换的钛等离子涂层非骨水泥 TKA 显示出优异的长期结果，具有较高的 10 年和 15 年组件生存率。临床和影像学结果与其他非骨水泥 TKA 相当，为骨关节炎膝关节的非骨水泥表面置换提供了进一步证据。
IV。
