Ersan Önder, Öztürk Alper, Çatma Mehmet Faruk, Ünlü Serhan, Akdoğan Mutlu, Ateş Yalım
University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Acta Orthop Traumatol Turc. 2017 Dec;51(6):433-436. doi: 10.1016/j.aott.2017.10.008. Epub 2017 Nov 1.
The aim of this study was to evaluate the long term clinical and radiological results of cementless total knee replacement.
A total of 51 knees of 49 patients (33 female and 16 male; mean age: 61.6 years (range, 29-66 years)) who underwent TKR surgery with a posterior stabilized hydroxyapatite coated knee implant were included in this study. All of the tibial components were fixed with screws. The HSS scores were examined preoperatively and at the final follow-up. Radiological assessment was performed with Knee Society evaluating and scoring system. Kaplan-Meier survival analysis was performed to rule out the survival of the tibial component.
The mean HSS scores were 45.8 (range 38-60) and 88.1 (range 61-93), preoperatively and at the final follow-up respectively. Complete radiological assessment was performed for 48 knees. Lucent lines at the tibial component were observed in 4 patients; one of these patients underwent a revision surgery due to the loosening of the tibial component. The 10-year survival rate of a tibial component was 98%.
Cementless total knee replacement has satisfactory long term clinical results. Primary fixation of the tibial component with screws provides adequate stability even in elderly patients with good bone quality.
Level IV, Therapeutic study.
本研究旨在评估非骨水泥型全膝关节置换术的长期临床和影像学结果。
本研究纳入了49例患者的51个膝关节（33例女性和16例男性；平均年龄：61.6岁（范围，29 - 66岁）），这些患者接受了后稳定型羟基磷灰石涂层膝关节假体的全膝关节置换术。所有胫骨组件均用螺钉固定。术前和末次随访时检查HSS评分。采用膝关节协会评估和评分系统进行影像学评估。进行Kaplan-Meier生存分析以排除胫骨组件的生存率。
术前和末次随访时的平均HSS评分分别为45.8（范围38 - 60）和88.1（范围61 - 93）。对48个膝关节进行了完整的影像学评估。4例患者观察到胫骨组件处有透亮线；其中1例患者因胫骨组件松动接受了翻修手术。胫骨组件的10年生存率为98%。
非骨水泥型全膝关节置换术具有令人满意的长期临床结果。即使在骨质良好的老年患者中，用螺钉对胫骨组件进行初次固定也能提供足够的稳定性。
IV级，治疗性研究。
