King T V, Scott R D
Clin Orthop Relat Res. 1985 Apr(194):285-90.
From experience with over 1600 condylar-type total knee arthroplasties performed between 1974 and 1981, the authors identified 15 knees in which the femoral component had loosened and shifted into flexion on the end of the femur. This mode of failure was related to inadequate support of the prosthetic posterior condyle, which resulted from inaccurate surgical cuts, poor cementing technique, or deficient bone stock either primary or secondary to persistent rheumatoid synovitis. Newer prosthetic designs that allow for greater range of motion and maximal function will further test the critical posterior condylar bone interface, as a result of which a higher incidence of femoral component loosening with flexion shift may be seen. Femoral component design changes and surgical techniques that sustain the posterior femoral condyle metal-bone interface may thus be necessary. Femoral components with intramedullary stems may be appropriate for high-risk patients.
根据1974年至1981年间进行的1600多例髁型全膝关节置换术的经验，作者发现有15例患者的股骨部件发生松动，并在股骨末端向屈曲方向移位。这种失败模式与假体后髁支撑不足有关，其原因包括手术切口不准确、骨水泥技术不佳，或原发性或继发性持续性类风湿性滑膜炎导致的骨量不足。允许更大活动范围和最大功能的新型假体设计将进一步考验关键的后髁骨界面，因此可能会出现更高的股骨部件因屈曲移位而松动的发生率。因此，可能需要改变股骨部件设计和手术技术，以维持股骨后髁金属-骨界面。带髓内柄的股骨部件可能适合高危患者。
