Matassi Fabrizio, Paoli Tommaso, Civinini Roberto, Carulli Christian, Innocenti Massimo
Orthopaedic Clinic, University of Florence, Department of Surgery and Translational Medicine, Florence, Italy.
Orthopaedic Clinic, University of Florence, Department of Surgery and Translational Medicine, Florence, Italy.
Knee. 2017 Oct;24(5):1160-1165. doi: 10.1016/j.knee.2017.04.012. Epub 2017 Jun 7.
Oxidized zirconium (OxZr) has demonstrated excellent mechanical properties in vitro when used against articular cartilage; less coefficient of friction and less chondral damage have been found when compared with cobalt-chromium (CoCr) implants. However, controversy exists as to whether implants with a zirconium femoral component articulate safely with a native patella in total knee arthroplasty (TKA). To answer this question, the clinical and radiographic results were analysed from a group of patients who underwent a TKA with patella retention; the OxZr versus CoCr femoral components were compared.
The present study prospectively evaluated 83 knees of 74 patients from 2009 to 2010. Each patient was evaluated clinically (visual analogue scale, Knee Society score, patellar score) and radiographically (long leg standing radiograph, anterior-posterior and latero-lateral projections, axial view of the patella) pre-operatively and postoperatively with a mean follow-up of 4.47years. The patellar tilt and shift, and progression of patellofemoral osteoarthritis were calculated with the axial view.
There were no patient reported adverse reactions and none of the evaluated prostheses failed. Both the clinical and radiographic evaluations showed no statistically significant between-group differences.
No adverse events were observed clinically or radiologically. These results justify pursuing the use of oxidized zirconium as an alternative bearing surface for a femoral component associated with patellar retention in TKA.
氧化锆（OxZr）在体外与关节软骨接触时已显示出优异的机械性能；与钴铬（CoCr）植入物相比，其摩擦系数更小，软骨损伤也更少。然而，在全膝关节置换术（TKA）中，带有锆股骨部件的植入物与天然髌骨之间能否安全铰接仍存在争议。为回答这个问题，我们分析了一组接受保留髌骨的TKA患者的临床和影像学结果；并比较了氧化锆与钴铬股骨部件。
本研究前瞻性评估了2009年至2010年74例患者的83个膝关节。每位患者在术前和术后均接受临床评估（视觉模拟量表、膝关节协会评分、髌骨评分）和影像学评估（长腿站立位X线片、前后位和侧位片、髌骨轴位片），平均随访4.47年。通过轴位片计算髌骨倾斜和移位以及髌股关节炎的进展情况。
没有患者报告不良反应，也没有评估的假体出现故障。临床和影像学评估均显示组间差异无统计学意义。
在临床和影像学上均未观察到不良事件。这些结果证明在TKA中使用氧化锆作为与保留髌骨相关的股骨部件的替代承重表面是合理的。
