Rand J A, Chao E Y, Stauffer R N
J Bone Joint Surg Am. 1987 Apr;69(4):489-97.
The first fifty kinematic rotating-hinge total knee arthroplasties that were done at the Mayo Clinic were reviewed. The indication for use of this prosthesis was either ligamentous instability or loss of bone, or both. At a mean length of follow-up of fifty months (range, twenty-nine to seventy-nine months), the clinical results of thirty-eight knees in thirty-six patients were evaluated. Fifteen of the thirty-eight knees had had a primary arthroplasty and twenty-three had had a revision arthroplasty using the kinematic rotating-hinge prosthesis. Using the knee-rating score of The Hospital for Special Surgery, there were fourteen excellent, twelve good, five fair, and five poor results. For two knees there was inadequate information to calculate a knee-rating score. Lucent lines that were more than one millimeter in width were seen with 25 per cent of the femoral and 50 per cent of the tibial components. Progression of lucent lines was observed in thirteen knees, and five knees showed probable radiographic loosening. The high incidence of complications was distressing, with a 16 per cent rate of sepsis, a 22 per cent rate of patellar instability, and a 6 per cent rate of breakage of the implant. In our opinion, this implant should be used only in knees in which there is functional absence of a collateral ligament that cannot be managed by soft-tissue reconstruction.
对梅奥诊所首批实施的50例运动学旋转铰链型全膝关节置换术进行了回顾。使用该假体的指征为韧带不稳定或骨质缺损，或两者皆有。平均随访时间为50个月（范围为29至79个月），对36例患者的38个膝关节的临床结果进行了评估。38个膝关节中，15个为初次置换，23个为使用运动学旋转铰链型假体进行的翻修置换。采用特殊外科医院膝关节评分系统，结果为14例优秀、12例良好、5例中等、5例较差。有2个膝关节因信息不足无法计算膝关节评分。25%的股骨假体组件和50%的胫骨假体组件出现了宽度超过1毫米的透亮线。13个膝关节观察到透亮线进展，5个膝关节显示可能存在影像学松动。并发症发生率较高令人担忧，败血症发生率为16%，髌骨不稳定发生率为22%，植入物断裂发生率为6%。我们认为，这种植入物仅应在无法通过软组织重建处理的侧副韧带功能缺失的膝关节中使用。
