Rand J A, Coventry M B
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
Clin Orthop Relat Res. 1988 Jul(232):168-73.
One hundred ninety-three geometric total knee arthroplasties (TKA) were performed between 1972 and 1975 in 129 patients (66 women, 63 men; mean age, 69 years) with osteoarthritis. Of these, 102 knees were followed for a mean of 11 years. Eighty-three percent of the patients had mild or no pain. The revision rate was 20%, and the surgical complication rate was 12%. By actuarial analysis, the probability of retaining a geometric prosthesis at 10 years was 78%. With revision or moderate to severe pain as the end point, the predicted implant survival was 69% at 10 years. Lucent lines greater than 1 mm were present in 38% of the knees and progressed in 34%; they were more frequent in knees with greater than or equal to 3 degrees of varus axial alignment (p less than 0.05) or greater than or equal to 4 degrees of varus placement of the tibial component (p less than 0.05). The geometric prosthesis has provided a functional result in 69% of knees at 10 years, despite being the first two-part component knee replacement retaining the cruciate ligaments and using early surgical instrumentation and implant design.
1972年至1975年间，对129例骨关节炎患者（66名女性，63名男性；平均年龄69岁）实施了193例几何型全膝关节置换术（TKA）。其中，102例膝关节接受了平均11年的随访。83%的患者疼痛轻微或无疼痛。翻修率为20%，手术并发症发生率为12%。通过精算分析，10年时保留几何型假体的概率为78%。以翻修或中度至重度疼痛为终点，预计10年时植入物生存率为69%。38%的膝关节出现了大于1 mm的透亮线，其中34%有进展；在膝关节内翻轴向对线≥3度（p<0.05）或胫骨组件内翻放置≥4度（p<0.05）的膝关节中更常见。尽管几何型假体是首个保留交叉韧带并使用早期手术器械和植入物设计的两部分组件膝关节置换术，但10年时仍有69%的膝关节获得了功能良好的结果。
