Mont M A, Mitzner D L, Jones L C, Hungerford D S
Orthopaedic Department, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Clin Orthop Relat Res. 1995 Dec(321):145-50.
Published reports of series of total knee replacements vary between 20% and 75% in the percentage of patients eventually having bilateral replacements. There are no data in the literature on the predicted course of the contralateral knee for patients presenting for total knee replacement. This study reviewed the history of the contralateral knee in patients with a diagnosis of osteoarthritis presenting for unilateral primary total knee arthroplasty. The current study group comprised 185 patients who had either a minimum 5 year followup (range 5-12.5 years) or who were known to have had a second knee arthroplasty before 5 years. Evaluation included a full clinical and radiographic examination of the contralateral knee at index arthroplasty and at final followup. Of the 185 patients, the contralateral side initially was asymptomatic in 36%, mildly symptomatic in 16%, moderately symptomatic in 28%, and severely symptomatic in 20%. Seventy-nine (43%) knees eventually underwent contralateral arthroplasty. Ninety-three percent of patients who had moderate or severe symptoms and severe radiographic arthritis of the contralateral side at the time of presentation later underwent total knee replacement. However, patients who presented initially with mild symptoms or who had no symptoms had only a 9% incidence of knee arthroplasty.
已发表的关于全膝关节置换系列病例的报告显示，最终接受双侧置换的患者比例在20%至75%之间。文献中没有关于接受全膝关节置换患者对侧膝关节预测病程的数据。本研究回顾了因单侧原发性全膝关节置换术就诊的骨关节炎患者对侧膝关节的病史。当前的研究组包括185例患者，这些患者要么至少有5年的随访期（范围为5至12.5年），要么已知在5年内进行了第二次膝关节置换术。评估包括在初次关节置换术时和最终随访时对侧膝关节的全面临床和影像学检查。在185例患者中，对侧膝关节最初无症状的占36%，轻度症状的占16%，中度症状的占28%，重度症状的占20%。79个（43%）膝关节最终接受了对侧关节置换术。初次就诊时对侧膝关节有中度或重度症状且有严重影像学关节炎的患者中，93%后来接受了全膝关节置换术。然而，最初表现为轻度症状或无症状的患者膝关节置换术的发生率仅为9%。
