Convery F R, Minteer-Convery M, Malcom L L
J Bone Joint Surg Am. 1980 Apr;62(3):320-7.
The purpose of this study was to assess prospectively the initial results of total knee replacement with the standard spherocentric component and to identify retrospectively the pathogenesis of any unsatisfactory results. As a consequence of this study, the femoral component was modified. Thirty-six knees were reviewed twenty-two to fifty-two months after a standard spherocentric total knee replacement, with a mean follow-up of thirty-five months. Twenty-five (70 per cent) of the knees had significant relief of pain and improved function. Eleven knees were not improved because of confirmed loosening in five, supracondylar fracture in two, infection in one, and suspected loosening in three. Ten of these eleven complications became manifest within the first postoperative year. Alignment in the coronal plane was not consistently precise and hyperextension was a recurrent problem in twelve of the thirty-six knees. A modification in the femoral component was made: the stem was lengthened to 10.0 centimeters and the body was reoriented so that there was 5 degrees of valgus and 15 more degrees of posterior rotation than the original design. This modified prosthesis was used in twenty-five additional knees, with definite improvement in alignment, but the follow-up was insufficient to ascertain the effect of the modification on lossening and fracture.
本研究的目的是前瞻性评估标准球心组件全膝关节置换的初始结果，并回顾性确定任何不满意结果的发病机制。作为本研究的结果，股骨组件进行了改良。对36例接受标准球心全膝关节置换术后22至52个月的膝关节进行了评估，平均随访35个月。其中25例（70%）膝关节疼痛明显缓解，功能改善。11例膝关节未改善，原因包括5例确诊松动、2例髁上骨折、1例感染以及3例疑似松动。这11例并发症中有10例在术后第一年内出现。冠状面的对线并不始终精确，36例膝关节中有12例反复出现过伸问题。对股骨组件进行了改良：将柄延长至10.0厘米，并重新调整假体位置，使其外翻5度，后倾比原设计多15度。这种改良后的假体又用于另外25例膝关节，对线有了明显改善，但随访时间不足，无法确定改良对松动和骨折的影响。
