Napier Richard J, O'Neill Christopher, O'Brien Seamus, Doran Emer, Mockford Brian, Boldt Jens, Beverland David E
Orthopaedic Outcomes Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, Northern Ireland.
Akutklinik Siloah, Worbstrasse 324, CH 3073, Guemligen, Switzerland.
BMC Musculoskelet Disord. 2018 Jun 26;19(1):205. doi: 10.1186/s12891-018-2128-1.
The theoretical benefits of a mobile bearing design in Total Knee Arthroplasty (TKA) include increased articular surface conformity with a reduction in both polyethylene wear and implant interface shear. However, to date these theoretical advantages have not been translated into published evidence of superior survivorship. This paper presents the results of a prospective, non-comparative study evaluating the performance of the mobile bearing Low Contact Stress LCS Complete Rotating Platform TKA in a largely cementless cohort without patellar resurfacing.
237 consecutive patients (240 knees) undergoing primary TKA were prospectively recruited. All received the LCS Complete Rotating Platform TKA (DePuy International, Leeds, UK). Clinical and radiographic assessments were performed at 3, 12, 60 and 120 months post-operatively. Radiographic evaluation was performed by an independent external surgeon.
The mean age was 70.3 years. 77.5% of cases were cementless. Radiographic assessment suggested excellent femoral component fixation. 22 tibial radiolucent lines (RLLs) > 1 mm were observed in 12 knees. No RLLs were progressive. There have been two revisions; one for late infection and one for aseptic loosening. No patients underwent secondary patellar resurfacing. The cumulative implant survivorship, using component revision for any reason as the endpoint, was 98.9% (95% CI, 95.6 to 99.7%) at 10 years.
The excellent survivorship at a minimum 10-year follow-up supports the use of uncemented porous coated fixation without patellar resurfacing with the non-posterior stabilized LCS Complete Rotating Platform TKA.
全膝关节置换术（TKA）中活动轴承设计的理论优势包括增加关节面贴合度，减少聚乙烯磨损和植入物界面剪切力。然而，迄今为止，这些理论优势尚未转化为已发表的关于更高生存率的证据。本文介绍了一项前瞻性、非对照研究的结果，该研究评估了活动轴承低接触应力LCS全旋转平台TKA在一个基本无骨水泥且未进行髌骨表面置换的队列中的性能。
前瞻性招募了237例连续接受初次TKA的患者（240膝）。所有患者均接受LCS全旋转平台TKA（英国利兹的DePuy International公司）。术后3、12、60和120个月进行临床和影像学评估。影像学评估由一名独立的外部外科医生进行。
平均年龄为70.3岁。77.5%的病例为无骨水泥型。影像学评估显示股骨组件固定良好。在12膝中观察到22条>1mm的胫骨透亮线（RLLs）。没有RLLs进展。有两次翻修；一次是因为晚期感染，一次是因为无菌性松动。没有患者接受二次髌骨表面置换。以因任何原因进行组件翻修为终点，10年时植入物的累积生存率为98.9%（95%CI，95.6至99.7%）。
至少10年随访的优异生存率支持在未进行髌骨表面置换的情况下，使用无骨水泥多孔涂层固定的非后稳定型LCS全旋转平台TKA。
