Ranawat C S, Padgett D E, Ohashi Y
New York Hospital, Cornell University Medical College, New York.
Clin Orthop Relat Res. 1989 Nov(248):27-33.
There are few reports in the literature that deal with the results of total knee arthroplasty in the younger patient. The present study was undertaken to evaluate the results of total knee arthroplasty in patients under the age of 55 years. Ninety-three knee arthroplasties in 62 patients were performed between 1974 and 1982. The preoperative diagnosis was rheumatoid arthritis in 76 knees and osteoarthritis in 17 knees. The total condylar knee prosthesis was used in all knees. Defects in the tibial plateau were noted in 13 knees, and supplemental support was required. Ninety knees (17 with osteoarthritis and 73 with rheumatoid arthritis) were available for follow-up study at a mean of 6.1 years. The knee rating for the entire group was 87.1. The subgroup scores for the osteoarthritis and rheumatoid arthritis groups were also 87.1. Roentgenographic evaluation revealed a lucency rate of 30%. Two implants were found to have global radiolucencies and were considered loose. Survivorship analysis resulted in a cumulative survivorship rate of 96% at ten years for the entire group. These results are comparable to the long-term results of total knee arthroplasty in the older patient and better than the results of total hip arthroplasty in the younger patient. Total knee arthroplasty in the younger patient is a reliable and durable procedure but should be used with caution despite the excellent results reported here.
文献中很少有关于年轻患者全膝关节置换术结果的报道。本研究旨在评估55岁以下患者全膝关节置换术的结果。1974年至1982年间，对62例患者进行了93次膝关节置换术。术前诊断为类风湿性关节炎的有76膝，骨关节炎的有17膝。所有膝关节均使用全髁膝关节假体。13膝发现胫骨平台有缺损，需要补充支撑。90膝（17例骨关节炎和73例类风湿性关节炎）可进行平均6.1年的随访研究。整个组的膝关节评分是87.1。骨关节炎组和类风湿性关节炎组的亚组评分也是87.1。X线评估显示透亮率为30%。发现两个植入物有整体透亮区，被认为是松动的。生存分析得出整个组在十年时的累积生存率为96%。这些结果与老年患者全膝关节置换术的长期结果相当，且优于年轻患者全髋关节置换术的结果。年轻患者的全膝关节置换术是一种可靠且持久的手术，但尽管这里报道了出色的结果，仍应谨慎使用。
