Dalury David F, Barrett William P
The St. Joseph Medical Center, 7601 Osler Dr, Towson, MD 21204, United States.
Proliance Orthopedic Associates, 4011 Talbot Rd. S., Renton, WA 98055, United States.
Knee. 2016 Jun;23(3):545-8. doi: 10.1016/j.knee.2016.02.005. Epub 2016 Mar 2.
Bone loss in revision total knee arthroplasty is common. Various reconstruction options are available. The purpose of our study is to report on one such reconstruction option, titanium metaphyseal sleeves.
We describe a series of 45 patients (46 knees) who underwent revision total knee arthroplasty and were treated with a porous metaphyseal sleeve between August 2000 and September 2009 at two centers. Patients were followed for a minimum of four years, and at final follow-up, 40 patients (40 knees) were available for review. Patients were evaluated using The Knee Society's Knee Scoring System at each follow-up. Radiographs (standing anteroposterior, lateral, and sunrise views) were taken at six weeks, three months, and final evaluations.
Mean Knee Society Scores increased from 36 (range 10 to 69) pre-operatively to 90 (range 38 to 100) at final follow-up. Mean alignment on final radiographic evaluation was 5° (range 3° to 8° valgus). Mean pre-operative alignment was 6° (range 15° varus to 18° valgus). Mean range of motion was 125° (range 80° to 140°) pre-operatively and 115° (range 95° to 130°) postoperatively. One device failed to achieve ingrowth and was revised at two years. All other knees were radiographically stable and ingrown.
Metaphyseal sleeves provide an alternative for bone loss reconstruction in revision total knee arthroplasty.
III.
全膝关节置换翻修术中骨量丢失很常见。有多种重建选择。我们研究的目的是报告一种这样的重建选择，即钛干骺端套筒。
我们描述了2000年8月至2009年9月期间在两个中心接受全膝关节置换翻修术并使用多孔干骺端套筒治疗的45例患者（46膝）。对患者进行了至少四年的随访，在最后一次随访时，有40例患者（40膝）可供评估。每次随访时使用膝关节协会的膝关节评分系统对患者进行评估。在术后六周、三个月和最后评估时拍摄X线片（站立位前后位、侧位和日出位）。
膝关节协会平均评分从术前的36分（范围10至69分）提高到最后随访时的90分（范围38至100分）。最后X线评估时的平均对线为5°（范围3°至8°外翻）。术前平均对线为6°（范围15°内翻至18°外翻）。术前平均活动范围为125°（范围80°至140°），术后为115°（范围95°至130°）。有一个装置未能实现骨长入，在两年时进行了翻修。所有其他膝关节在X线片上均稳定且已骨长入。
干骺端套筒为全膝关节置换翻修术中骨量丢失重建提供了一种替代方法。
III级。
