Ranawat C S, Flynn W F, Deshmukh R G
Lenox Hill Hospital, New York, NY 10021.
Clin Orthop Relat Res. 1994 Dec(309):131-5.
This study reports the 14-year survivorship for 106 consecutive total condylar knee arthroplasties implanted using modern technique. All were performed by a single surgeon and have been observed prospectively since 1979. Failure was defined as revision for any reason, or radiographic evidence of loosening of the components. Life-table analysis reveals a 95.6% clinical survival rate at 14 years, with no radiographically loose components. Confidence interval is +/- 4.2%. There were 4 revisions, but none for aseptic loosening, and there are no impending revisions. Thirty-seven patients (49 knees) were known to be deceased as of April 1993, and 8 other patients are lost to followup. Clinical results for patients with pre- and postoperative Hospital For Special Surgery knee scores show 72 knees rated excellent and 11 good (mean score, 90 points). The 4 failures were rated poor. Mean flexion was 100 degrees. Radiographs of 93 knees were evaluated using the criteria of the Knee Society. Average overall alignment was 5 degrees valgus. Radiolucencies were present in 29 of 78 femoral components with adequate radiographs, and averaged 1 mm in 1 zone. Tibial radiolucency was present in 42 of 93 tibiae, again averaging 1 mm in 1 zone, with no loose pegs. In comparison with the first series of total condylar prostheses, this series showed comparable clinical results, with improved radiographic results, and no radiographic failures.
本研究报告了采用现代技术连续植入的106例全髁膝关节置换术的14年生存率。所有手术均由同一外科医生完成，自1979年以来一直进行前瞻性观察。失败定义为因任何原因进行翻修，或假体组件出现影像学松动证据。生命表分析显示，14年的临床生存率为95.6%，假体组件无影像学松动。置信区间为±4.2%。有4例进行了翻修，但均非因无菌性松动，且目前没有即将进行翻修的情况。截至1993年4月，已知37例患者（49膝）死亡，另有8例患者失访。根据特殊外科医院膝关节评分系统对术前和术后患者的临床结果进行评估，结果显示72膝为优，11膝为良（平均评分90分）。4例失败病例评为差。平均屈曲度为100度。采用膝关节协会的标准对93膝的X线片进行评估。平均整体对线为外翻5度。在78例有足够X线片的股骨组件中，29例存在透亮线，在1个区域平均为1mm。93例胫骨中有42例存在胫骨透亮线，同样在1个区域平均为1mm，且无松动的固定钉。与第一系列全髁假体相比，本系列显示出相当的临床结果，影像学结果有所改善，且无影像学失败病例。
