Elmenawi Khaled A, Gonzalez-Bravo Adrian E, Prokop Larry J, Hannon Charles P, Abdel Matthew P, Bedard Nicholas A
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota.
J Knee Surg. 2025 Aug;38(10):505-511. doi: 10.1055/a-2509-3442. Epub 2025 Jan 6.
Historically, cementless patellar implants were fraught with issues of fixation and polyethylene wear. However, contemporary cementless patellar implants incorporate modern technologies for implant design and offer the potential for improved biological fixation and longevity. As such, an evaluation of the performance of modern cementless patellae is needed. The purpose of this study was to perform a systematic review and meta-analysis of contemporary cementless patellar implants used during primary total knee arthroplasty (TKA), with a particular focus on aseptic loosening of the patellar component. A systematic review of the literature was performed from January 2000 to February 22, 2024. We included all peer-reviewed studies that reported the number of revisions in patients who had cementless patellae placed in 2000 or later during primary TKA. Reviews and case reports were excluded. Out of 639 studies, 13 were included with a total of 3,005 cementless patellae analyzed. The mean patient age was 64 years and the mean body mass index (BMI) was 31 kg/m. Meta-analyses were performed to calculate the pooled revision rate per person-year of revision for aseptic loosening of the patellar component and revision for any patellar failure. Upon analysis of 13 studies involving a total of 3,005 cementless patellae, the revision rate for aseptic loosening of the patella was 0.2 per 1,000 person-years and the revision rate for any patellar failure was 1 per 1,000 person-years. Contemporary cementless patellar implants showed an overall revision rate of 1 per 1,000 person-years, demonstrating excellent longevity. The high survivorship, together with a low rate of loosening, show the utility and effectiveness of these implants. Given the nature of biologic fixation, these results are promising for long-term implant stability but additional follow-up is warranted.
从历史上看，非骨水泥型髌骨植入物存在固定和聚乙烯磨损等诸多问题。然而，当代非骨水泥型髌骨植入物采用了现代的植入物设计技术，具有改善生物固定和延长使用寿命的潜力。因此，有必要对现代非骨水泥型髌骨的性能进行评估。本研究的目的是对初次全膝关节置换术（TKA）中使用的当代非骨水泥型髌骨植入物进行系统评价和荟萃分析，特别关注髌骨部件的无菌性松动。我们对2000年1月至2024年2月22日的文献进行了系统回顾。我们纳入了所有经同行评审的研究，这些研究报告了在2000年或之后初次TKA期间植入非骨水泥型髌骨的患者的翻修次数。综述和病例报告被排除在外。在639项研究中，有13项被纳入，共分析了30０5个非骨水泥型髌骨。患者的平均年龄为64岁，平均体重指数（BMI）为31kg/m²。进行荟萃分析以计算髌骨部件无菌性松动和任何髌骨失败的每人每年翻修率。在分析涉及总共3005个非骨水泥型髌骨的13项研究后，髌骨无菌性松动的翻修率为每1000人年0.2次，任何髌骨失败的翻修率为每1000人年1次。当代非骨水泥型髌骨植入物的总体翻修率为每1000人年1次，显示出出色的使用寿命。高生存率以及低松动率表明了这些植入物的实用性和有效性。鉴于生物固定的性质，这些结果对于植入物的长期稳定性很有前景，但仍需要进一步随访。
