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全髁膝关节置换术的生存分析及结果。8至11年随访期。

Survivorship analysis and results of total condylar knee arthroplasty. Eight- to 11-year follow-up period.

作者信息

Ranawat C S, Boachie-Adjei O

机构信息

Cornell University Medical College, New York Hospital, NY.

出版信息

Clin Orthop Relat Res. 1988 Jan(226):6-13.

PMID:3335108
Abstract

This study deals with survivorship of total condylar knee arthroplasties in 87 consecutive patients (112 knees) with follow-up periods of up to 11 years. The end point of the survivorship was defined as: (1) the need for revision due to septic or aseptic loosening; (2) roentgenographic loosening evidenced by a shift of component position; or (3) radiolucency extending under the condyle of the tibial component and partially along the peg, when associated with clinical symptoms. Life table calculations predict 88.7% survivorship of total condylar knee arthroplasty. Using revision for septic or aseptic loosening and recommendation for surgery as an end point, the survivorship was 94.1% 11 years after operation in this series. Seventy-two patients (90 knees) of 87 were available for clinical and roentgenographic study at eight to 11 years. Eight patients (12 knees) had died and seven patients (ten knees) were lost to follow-up study. The results were excellent to good in 93%, fair in 3%, and poor in 4%. Roentgenographic evaluation revealed well-fixed components in 36 knees (40%). Radiolucencies of varying degrees were present in 54 knees (60%). Of the 54 knees, seven had radiolucency under the tibial condyle in Zones I-IV and partially along the peg in Zones V and VI. Two knees had component loosening, one with a loose patella and the other a loose tibial component; both of these patients were symptomatic. Variables such as the patient's age, sex, diagnosis, alignment and position of the prosthesis, and level of bone cut did not correlate with the development of radiolucencies at the cement-bone interface.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究涉及87例连续患者(112膝)全髁膝关节置换术的生存率,随访期长达11年。生存率的终点定义为:(1)因感染性或无菌性松动而需要翻修;(2)假体位置改变所证实的影像学松动;或(3)当伴有临床症状时,胫骨假体髁下出现透光线并部分沿固定桩延伸。生命表计算预测全髁膝关节置换术的生存率为88.7%。以因感染性或无菌性松动进行翻修及手术建议作为终点,本系列患者术后11年的生存率为94.1%。87例患者中有72例(90膝)在8至11年时可进行临床和影像学研究。8例患者(12膝)死亡,7例患者(10膝)失访。结果优至良的占93%,一般的占3%,差的占4%。影像学评估显示36膝(40%)假体固定良好。54膝(60%)存在不同程度的透光线。在这54膝中,7膝在I-IV区胫骨髁下及V和VI区部分沿固定桩出现透光线。2膝出现假体松动,1例髌骨松动,另1例胫骨假体松动;这2例患者均有症状。患者的年龄、性别、诊断、假体的对线和位置以及截骨水平等变量与骨水泥-骨界面透光线的发生无关。(摘要截选至250字)

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