Joint Implant Surgeons, Inc., New Albany, OH; Mount Carmel Health System, New Albany, OH.
Valley Orthopedic Surgery, Modesto, CA.
J Arthroplasty. 2018 Sep;33(9):2800-2803. doi: 10.1016/j.arth.2018.03.070. Epub 2018 Apr 9.
Many total knee arthroplasty (TKA) systems allow for so-called midlevel constraint (MLC) articular bearings that can be used with primary implants. The purpose of this study is to report the early outcomes with MLC bearings in primary TKA.
MATERIALS/METHODS: From December 2005 to June 2015, minimum 2-year follow-up was available on 96 patients (103 TKA) who underwent primary TKA with an MLC bearing using the Vanguard Total Knee System. Outcomes included pain, Knee Society clinical and functional score, range of motion, and need for revision.
Mean follow-up was 5 years (range, 2-11 years). Range of motion improved from 103 to 113. Knee Society clinical and function scores improved from 28 and 43 to 88 and 62, respectively. There were 10 manipulations (9.9%). There were no failures for aseptic loosening of any components; however, 10% of patients were lost to follow-up. There were 3 revisions (3%): 1 patellar tendon rupture, 1 open lysis of adhesions for stiffness, and 1 2-stage treatment of infection.
In cases of intraoperative medial collateral ligament incompetence, severe deformity, or valgus deformity requiring release of the lateral collateral ligament, the use of MLC showed good survivorship with no cases of aseptic loosening or instability.
许多全膝关节置换术（TKA）系统允许使用所谓的中等级别约束（MLC）关节轴承，这些轴承可与初次植入物一起使用。本研究的目的是报告初次 TKA 中使用 MLC 轴承的早期结果。
材料/方法：从 2005 年 12 月至 2015 年 6 月，共有 96 例患者（103 例 TKA）接受了 Vanguard 全膝关节系统的 MLC 轴承初次 TKA，至少随访 2 年。结果包括疼痛、膝关节协会临床和功能评分、活动范围和需要翻修。
平均随访时间为 5 年（范围，2-11 年）。活动范围从 103 度增加到 113 度。膝关节协会临床和功能评分分别从 28 分和 43 分提高到 88 分和 62 分。有 10 次翻修（9.9%）。没有任何组件无菌性松动的失败；然而，有 10%的患者失访。有 3 次翻修（3%）：1 例髌腱断裂，1 例因僵硬而行粘连松解术，1 例 2 期治疗感染。
在术中内侧副韧带功能不全、严重畸形或需要松解外侧副韧带的外翻畸形的情况下，使用 MLC 显示出良好的存活率，无无菌性松动或不稳定的病例。
