Rööser B, Boegård T, Knutson K, Rydholm U, Lidgren L
Clin Orthop Relat Res. 1987 Jun(219):169-73.
Seventy-six revised total knee arthroplasties (TKAs) performed for mechanical, nonseptic failure of the primary arthroplasty in 62 rheumatoid arthritis patients were investigated. The revisions were performed with McIntosh, Marmor, Attenborough, Guepar, and various types of tricompartmental prostheses. Twenty-one of the 76 revisions subsequently failed. Fifteen were mechanical failures and six were deep infections. Thirteen of the 21 failures were treated with another arthroplasty, six with arthrodesis, and two with antibiotics only. After an average of 60 months, 48 of the surviving arthroplasties were examined clinically and roentgenographically. At follow-up examination, eight were clinical failures. One-half of the McIntosh and Marmor arthroplasties and one-third of the Attenborough and Guepar arthroplasties, altogether 17 cases, showed signs of potential roentgenographic failure. The majority of the revised TKAs classified as roentgenographic failures were clinically successful or acceptable. Revision of TKAs in noninfected rheumatoid patients can be performed with acceptable clinical results but with a significantly higher failure rate than after primary procedures.
对62例类风湿性关节炎患者因初次关节置换术出现机械性、非感染性失败而进行的76例翻修全膝关节置换术（TKA）进行了研究。翻修采用麦金托什、马莫尔、阿滕伯勒、盖帕尔以及各种类型的三腔室假体。76例翻修中，有21例随后失败。15例为机械性失败，6例为深部感染。21例失败病例中，13例接受了另一次关节置换术治疗，6例接受了关节融合术，2例仅接受了抗生素治疗。平均60个月后，对48例存活的关节置换术进行了临床和影像学检查。在随访检查中，8例为临床失败。麦金托什和马莫尔关节置换术的一半以及阿滕伯勒和盖帕尔关节置换术的三分之一，共17例，显示出潜在的影像学失败迹象。大多数被归类为影像学失败的翻修TKA在临床上是成功的或可接受的。非感染性类风湿患者的TKA翻修术可取得可接受的临床结果，但失败率明显高于初次手术。
