Insall J, Tria A J, Scott W N
Clin Orthop Relat Res. 1979 Nov-Dec(145):68-77.
The total condylar knee prosthesis evolved from previous experience with other prostheses at the Hospital for Special Surgery. This evolution includes patellar resurfacing. Subsequent modifications have led to the total condylar knee prosthesis II (a cruciate substituting prosthesis), and the total condylar knee prosthesis III (a TCP II with increased constraint). The surgical technique requires ligamentous balance with correction of preoperative deformity by a soft-tissue release. Subsequently a standard operation is performed. Four hundred and sixty-one knees were reviewed with a minimum of one year follow-up and a maximum of 5 years. Seventy-five per cent were osteoarthritic knees. Using the Hospital for Special Surgery Knee Rating Scale, the results were excellent in 312 knees (68%), good in 109 knees (23.5%), fair in 18 knees (4%) and poor in 22 knees (4.5%). Osteoarthritic knees (excellent or good 93.5%) did slightly better than rheumatoid knees (excellent or good 87%). Complications include 6 infections, 6 subluxations and 10 cases of component loosening. There were 15 reoperations (3%). The results approach total hip arthroplasty in quality and so far have not deteriorated with time.
全髁膝关节假体是由特殊外科医院以往使用其他假体的经验发展而来的。这一发展包括髌骨表面置换。随后的改进产生了全髁膝关节假体II（一种交叉韧带替代假体）和全髁膝关节假体III（一种约束性增加的全髁膝关节假体II）。手术技术要求通过软组织松解来平衡韧带并纠正术前畸形。随后进行标准手术。对461例膝关节进行了至少1年、最长5年的随访。其中75%为骨关节炎膝关节。使用特殊外科医院膝关节评分量表，结果为312例膝关节（68%）优，109例膝关节（23.5%）良，18例膝关节（4%）中，22例膝关节（4.5%）差。骨关节炎膝关节（优或良占93.5%）的表现略优于类风湿性膝关节（优或良占87%）。并发症包括6例感染、6例半脱位和10例假体松动。有15例再次手术（3%）。结果在质量上接近全髋关节置换术，并且迄今为止尚未随时间而恶化。
