Outcomes Unit, Primary Joint Unit, Department of Orthopaedics, Musgrave Park Hospital, Belfast, United Kingdom.
Department of Orthopaedics, OrthoBoldt AG, Bern, Switzerland.
J Arthroplasty. 2019 Mar;34(3):508-512. doi: 10.1016/j.arth.2018.11.024. Epub 2018 Nov 23.
Total knee arthroplasty designs can be categorized by bearing design and fixation method. The mobile-bearing concept was developed with the aim of increasing longevity and improving function by reduced polyethylene wear and closer replication of physiological knee motion. Cementless fixation has the goal of achieving a long-lasting "biological" fixation between prosthesis and bone.
Prospective analysis of the survivorship and patient-reported functional outcomes of a series of 500 low contact stress rotating-platform mobile-bearing total knee arthroplasties with a cementless tibial component with a minimum 17-year follow-up.
Five hundred primary total knee arthroplasties were conducted in 467 patients. Mean follow-up was 18.1 (17.0-21.8) years and 141 (28.2%) knees were alive and available for review. Using revision for any cause as the end point, cumulative survivorship was 97.4%. Thirteen knees required revision: 3 for deep infection, 3 bearing only revisions for spinout, 3 for tibial tray subsidence, 2 secondary patella resurfacings, 1 aseptic loosening, and 1 for suspected aseptic loosening that was found to be well fixed. Mean American Knee Society Scores were 83 (evaluation) and 48 (function), Mean Oxford Knee Score was 32.1, and the mean Bartlett Patellar Score was 21.6.
This series demonstrates excellent survivorship and acceptable patient-reported functional outcome scores of a mobile-bearing total knee arthroplasty with a cementless tibial tray at minimum 17-year follow-up.
全膝关节置换术的设计可根据轴承设计和固定方式进行分类。 活动衬垫的概念是为了通过减少聚乙烯磨损和更接近生理膝关节运动来提高寿命和改善功能而开发的。 非骨水泥固定的目的是在假体和骨骼之间实现持久的“生物”固定。
对一系列 500 例低接触应力旋转平台活动衬垫非骨水泥胫骨组件的全膝关节置换术的生存率和患者报告的功能结果进行前瞻性分析，这些患者的随访时间至少为 17 年。
在 467 例患者中进行了 500 例原发性全膝关节置换术。 平均随访时间为 18.1 年（17.0-21.8 年），有 141 例（28.2%）膝关节存活并可供复查。 以任何原因进行翻修为终点，累积生存率为 97.4%。 有 13 例膝关节需要翻修：3 例深部感染，3 例因旋转脱出仅行轴承翻修，3 例胫骨托沉降，2 例二次髌骨再表面化，1 例无菌性松动，1 例疑似无菌性松动，发现固定良好。 平均美国膝关节协会评分（评估）为 83 分，功能评分为 48 分，平均牛津膝关节评分为 32.1 分，巴特利特髌骨评分为 21.6 分。
在至少 17 年的随访中，本系列证明了活动衬垫全膝关节置换术具有非骨水泥胫骨托的出色生存率和可接受的患者报告功能结果。
