Passias Braden J, Adams Joanne B, Lombardi Adolph V, Berend Keith R, Crawford David A
Department of Orthopedic Surgery, OhioHealth, Columbus, Ohio.
Joint Implant Surgeons, Inc., New Albany, Ohio.
Surg Technol Int. 2020 Nov 28;37:259-264.
With the growing demand for total knee arthroplasty (TKA), the burden of revision surgery will continue to rise. Revision knee arthroplasty has historically had worse survivorship than primary knee arthroplasty. The purpose of this study is to review the 10-year outcomes and survivorship of a modular revision knee system.
A retrospective review was conducted on 109 patients (117 knees) who underwent a revision knee arthroplasty with the Vanguard® Super Stabilized Knee (SSK) Revision System (Zimmer Biomet; Warsaw, Indiana) who were eligible for 10-year minimum follow up. Clinical and radiographic data was obtained pre- and postoperatively, six weeks postoperatively, and then every year thereafter.
With an average follow up of 10.7 years (range, 2.3 to 14.1 years), the SSK revision system exhibited a notable improvement in both clinical and functional outcomes. Average knee range of motion improvement was 4.2 degrees (SD ±18). Manipulations under anesthesia were performed in six knees (5%). Re-revisions occurred in 27 knees (23%). Ten of the re-revisions were for aseptic loosening (37%), eight for periprosthetic infection (30%), five for instability (19%), and the remainder for other aseptic causes. Mean time to failure was 4.6 years (range, 1 to 9.1 years). The 10-year all-cause survival was 77% (95% confidence interval [CI], 73 to 81%). The 10-year aseptic survival was 83% (95% CI, 79 to 87%).
The findings of this study show an 83% 10-year aseptic survivorship with the Vanguard® SSK knee revision system. These results are comparable to long-term follow up of other revision knee systems.
随着全膝关节置换术（TKA）需求的不断增长，翻修手术的负担将持续增加。历史上，膝关节翻修术的生存率一直低于初次膝关节置换术。本研究的目的是回顾一种模块化翻修膝关节系统的10年疗效和生存率。
对109例患者（117膝）进行回顾性研究，这些患者接受了使用Vanguard®超稳定膝关节（SSK）翻修系统（捷迈邦美公司；印第安纳州华沙）的膝关节翻修术，且至少有10年的随访时间。术前、术后、术后六周以及此后每年获取临床和影像学数据。
平均随访10.7年（范围为2.3至14.1年），SSK翻修系统在临床和功能疗效方面均有显著改善。膝关节平均活动范围改善了4.2度（标准差±18）。6例膝关节（5%）接受了麻醉下手法操作。27例膝关节（23%）进行了再次翻修。其中10例再次翻修是由于无菌性松动（37%），8例是由于假体周围感染（30%），5例是由于不稳定（19%），其余是由于其他无菌性原因。平均失效时间为4.6年（范围为1至9.1年）。10年全因生存率为77%（95%置信区间[CI]，73至81%）。10年无菌生存率为83%（95%CI，79至87%）。
本研究结果显示，Vanguard® SSK膝关节翻修系统的10年无菌生存率为83%。这些结果与其他翻修膝关节系统的长期随访结果相当。
