Bugbee W D, Ammeen D J, Parks N L, Engh G A
Department of Orthopaedics, University of California, San Diego, USA.
Clin Orthop Relat Res. 1998 Mar(348):158-65.
The outcome of 186 consecutive total knee arthroplasties performed with the Anatomic Modular Knee is reported. One hundred forty-two knees had followup of 4 to 10 years (mean, 6.9 years). Two knees required revision of all components, one because of infection and the other for instability. Seven patients underwent exchange of the modular tibial polyethylene insert at an average of 84 months postoperatively. The mean age of these seven patients at primary arthroplasty was 54 years. No implant showed clinical or radiographic evidence of loosening and there were no complications related to patellofemoral articulation. The revision rate of the femoral, tibial, and patellar components was two of 142 or 1.4%. The revision rate including exchange of the polyethylene insert was nine of 142 or 6.3%. This minimally constrained posterior cruciate retaining modular design performed well at intermediate followup. The absence of patellofemoral complications and aseptic loosening was notable. Wear related phenomena were the most common indications for reoperation and these occurred in younger, active individuals with relatively thin polyethylene bearings. The relative value of modular tibial inserts and the outcome of isolated polyethylene exchanges warrant additional study.
报告了连续186例使用解剖型模块化膝关节进行的全膝关节置换术的结果。其中142例膝关节接受了4至10年的随访（平均6.9年）。2例膝关节需要翻修所有组件，1例因感染，另1例因不稳定。7例患者在术后平均84个月时进行了模块化胫骨聚乙烯内衬的更换。这7例患者初次置换时的平均年龄为54岁。没有植入物出现临床或影像学上的松动迹象，也没有与髌股关节相关的并发症。股骨、胫骨和髌骨组件的翻修率为142例中的2例，即1.4%。包括聚乙烯内衬更换在内的翻修率为142例中的9例，即6.3%。这种微创限制后交叉韧带保留模块化设计在中期随访时表现良好。髌股关节无并发症和无菌性松动值得关注。磨损相关现象是再次手术最常见的原因，这些情况发生在年龄较轻、活动较多且聚乙烯衬垫相对较薄的个体中。模块化胫骨内衬的相对价值以及单纯聚乙烯内衬更换的结果值得进一步研究。
