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全髁型III型和限制性髁型全膝关节置换术的临床及影像学结果

Clinical and radiographic results of the Total Condylar III and Constrained Condylar total knee arthroplasty.

作者信息

Lachiewicz P F, Falatyn S P

机构信息

Department of orthopaedic Surgery, University of North Carolina, Chapel Hill, USA.

出版信息

J Arthroplasty. 1996 Dec;11(8):916-22. doi: 10.1016/s0883-5403(96)80132-x.

Abstract

The Total Condylar III (Johnson and Johnson, Braintree, MA) and Constrained Condylar (Zimmer, Warsaw, IN) knee prostheses are nonlinked, semi-constrained prosthetic alternatives to rigid or rotating hinge prostheses for use in complex knee reconstructions. Forty-six Total Condylar III or Constrained Condylar prostheses were implanted with cement in 36 patients and followed for a mean of 5 years (range, 2-9 years). There were 25 primary total knee arthroplasties and 21 revision total knee arthroplasties. The knees were evaluated using The Hospital for Special Surgery 100-point knee rating system. Overall, 40 knees (87%) had a good or excellent clinical result, 2 knees (4%) had a fair result, and 4 knees (9%) had a poor result. There was one revision for loosening of a cemented, nonmodular Constrained Condylar prosthesis, and one knee had a debridement for a late, metastatic infection, but the components were retained. There were no mechanical failures in those knees that were primary arthroplasties, but two mechanical failures occurred in those knees that were revision arthroplasties. Radiographic review showed one asymptomatic loosening of a Constrained Condylar tibial component with an uncemented press-fit stem, and only 8 knees had scattered nonprogressive tibial bone-cement radiolucent lines. The Total Condylar III and Constrained Condylar semiconstrained prostheses are successful when used in complex knee reconstructions.

摘要

全髁型III型(强生公司,马萨诸塞州布伦特里)和限制型髁型(捷迈公司,印第安纳州华沙)膝关节假体是非铰链式、半限制型假体,可替代刚性或旋转铰链式假体用于复杂的膝关节重建。36例患者共植入46个全髁型III型或限制型髁型假体并使用骨水泥固定,平均随访5年(范围2 - 9年)。其中有25例初次全膝关节置换术和21例全膝关节翻修术。采用特种外科医院100分膝关节评分系统对膝关节进行评估。总体而言,40个膝关节(87%)临床结果为良好或优秀,2个膝关节(4%)结果一般,4个膝关节(9%)结果较差。有1例因骨水泥固定的非模块化限制型髁型假体松动而进行翻修,1例膝关节因晚期转移性感染进行清创,但保留了假体组件。初次置换的膝关节未发生机械故障,但翻修的膝关节出现了2例机械故障。影像学检查显示1例采用非骨水泥压配柄的限制型髁型胫骨组件出现无症状性松动,只有8个膝关节有散在的非进行性胫骨骨水泥透亮线。全髁型III型和限制型髁型半限制型假体用于复杂膝关节重建时是成功的。

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