Freeman M A, Levai J P
Ann Acad Med Singap. 1983 Apr;12(2):213-24.
The Imperial College London Hospital (ICLH) technique and prosthesis for the total replacement of the knee was evolved over the period 1968 to 1977. The results now reported were obtained at The London Hospital on rheumatoid knees operated upon in the period 1977 to 1979. These knees were reviewed and the results published with a one to 2 year follow-up in 1981. In the present paper this review has been extended to 3 to 5 years. We find that in successfully replaced knees the quality of the clinical result has remained unchanged over the extended period of review. Certain further complications have been encountered which are described. These complications have led us to the conclusion that whereas we previously accepted post-operative alignments between one and 10 degrees of valgus, we should now adjust these limits. We now regard a knee having anything less than 5 degrees of valgus post-operatively as having been incorrectly replaced. The limits of valgus can perhaps be extended to 15 degrees. Experience over the period 1977 to 1980 suggested the possibility of further improvements in both the operative technique and the prosthesis. Accordingly the ICLH prosthesis has now been modified. The modified prosthesis (the Freeman-Samuelson prosthesis) is described in this paper but results with it are not reported.
伦敦帝国学院医院（ICLH）的全膝关节置换技术及假体是在1968年至1977年期间逐步发展起来的。本文所报告的结果是在伦敦医院对1977年至1979年期间接受手术的类风湿性膝关节进行治疗后获得的。这些膝关节经过复查，并于1981年发表了随访1至2年的结果。在本文中，该复查已延长至3至5年。我们发现，在成功置换的膝关节中，临床结果的质量在延长的复查期内保持不变。还遇到了一些其他并发症并予以描述。这些并发症使我们得出结论，尽管我们以前接受术后外翻角度在1度至10度之间，但现在我们应该调整这些限度。我们现在认为，术后外翻角度小于5度的膝关节置换是不正确的。外翻限度或许可以扩大到15度。1977年至1980年期间的经验表明，手术技术和假体都有可能进一步改进。因此，ICLH假体现已进行了改良。本文描述了改良后的假体（弗里曼 - 萨缪尔森假体），但未报告其使用结果。
