Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands; Specialized Center of Orthopedic Research and Education (SCORE), Xpert Orthopedie, Amsterdam, the Netherlands.
J Arthroplasty. 2022 Aug;37(8):1586-1593. doi: 10.1016/j.arth.2022.03.074. Epub 2022 Mar 30.
The aim of this study is to evaluate the survival, radiographic, and functional outcomes of the uncemented "meniscal bearing" cruciate-retaining Low Contact Stress (LCS) (DePuy Synthes, Warsaw, IN, USA) total knee system after a long-term follow-up period.
A total of 56 patients (67 knees) who received an uncemented "meniscal bearing" cruciate-retaining LCS total knee system between 2000 and 2005 were retrospectively reviewed. Patients were 64 ± 7 years old with osteoarthritis as the indication for arthroplasty. The survivorship, radiographs, and patient-reported outcome measures (PROMs) were analyzed.
The all-cause survival after 5, 10, 15, and 18 years was 97.0%, 93.8%, 92.0%, and 92.0%, respectively. Survival with revision for aseptic loosening as an end point was 98.4% at 5 years and 96.7% at 10, 15, and 18 years. Reasons of revisions and their interventions consisted of anterior knee pain requiring secondary patellar resurfacing (n = 3, 60%), polyethylene wear requiring an insert exchange (n = 2, 40%), and bearing spin-out requiring an insert exchange (n = 1, 20%). Two of the 5 revision cases developed aseptic loosening of the tibial component later on during the study period. A radiographic analysis demonstrated radiolucent lines in 14/47 implants (30%) after 12.0 ± 3.8 years, but were not revised, respectively. After a mean follow-up of 18.5 years, PROMs (n = 20) were found comparable with the 1-year postoperative PROMs of all implants reported by the LROI (Dutch Arthroplasty Register).
This present study demonstrates good results of the uncemented "meniscal bearing" cruciate-retaining LCS total knee system toward survival and functional outcomes after a long-term median follow-up of 17.5 years.
Therapeutic retrospective cohort study, LEVEL III.
本研究旨在评估非骨水泥“半月板支撑”保留交叉韧带的低接触应力（LCS）（Depuy Synthes，印第安纳州华沙）全膝关节系统在长期随访后的生存率、影像学和功能结果。
回顾性分析 2000 年至 2005 年间接受非骨水泥“半月板支撑”保留交叉韧带的 LCS 全膝关节系统的 56 例患者（67 膝）。患者年龄 64±7 岁，关节炎为关节置换指征。分析患者的生存率、影像学和患者报告的结果测量（PROM）。
5、10、15 和 18 年后的全因生存率分别为 97.0%、93.8%、92.0%和 92.0%。以无菌性松动为终点的生存率在 5 年时为 98.4%，在 10、15 和 18 年时分别为 96.7%。翻修的原因和干预措施包括需要二次髌骨表面置换的前膝痛（n=3，60%）、需要更换植入物的聚乙烯磨损（n=2，40%）和需要更换植入物的轴承旋转（n=1，20%）。研究期间，5 例翻修病例中有 2 例发生胫骨部件无菌性松动。放射学分析显示，14/47 个植入物（30%）在 12.0±3.8 年后出现透亮线，但未进行翻修。在平均 18.5 年的随访后，PROM（n=20）与 LROI（荷兰关节置换登记处）报告的所有植入物术后 1 年的 PROM 相当。
本研究显示，在长达 17.5 年的中位随访后，非骨水泥“半月板支撑”保留交叉韧带的 LCS 全膝关节系统在生存率和功能结果方面表现良好。
治疗性回顾性队列研究，III 级。
