Insall J N, Ranawat C S, Aglietti P, Shine J
J Bone Joint Surg Am. 1976 Sep;58(6):754-65.
Twenty-nine knees with unicondylar, sixty-four with duocondylar, fifty with Guepar, and fifty with geometric prostheses were studied. The follow-up ranged from two to three and one-half years. The unicondylar prosthesis was used in the mildest cases and gave the least complications, but the quality of results was not superior to that achieved with the other prostheses. The duocondylar model was best suited for knees with rheumatoid arthritis and mild deformity. The geometric prosthesis was the best condylar prosthesis for osteoarthritis with moderate to severe deformity, but gave the worst results in knees with rheumatoid arthritis. The Guepar prosthesis was used in the worst knees and gave the best results, but it had the highest infection rate and was the most difficult to salvage. A radiolucency was observed in about 60 per cent of the condylar replacements around the tibial component and in 45 per cent of the Geupar replacements around the femoral component. The significance of this cannot yet be determined but it suggest that the fixation may not be ideal. In all types, residual pain was most frequently attributed to the patellar compartment. Patellectomy was not a solution.
对29例使用单髁假体、64例使用双髁假体、50例使用盖帕尔（Guepar）假体和50例使用几何型假体的膝关节进行了研究。随访时间为2至3年半。单髁假体用于病情最轻的病例，并发症最少，但结果质量并不优于其他假体。双髁模型最适合类风湿性关节炎和轻度畸形的膝关节。几何型假体是治疗中度至重度畸形骨关节炎的最佳髁假体，但在类风湿性关节炎膝关节中效果最差。盖帕尔假体用于病情最严重的膝关节，效果最佳，但感染率最高，最难挽救。在约60%的胫骨部件周围髁置换和45%的股骨部件周围盖帕尔置换中观察到透亮区。其意义尚无法确定，但提示固定可能不理想。在所有类型中，残留疼痛最常归因于髌股关节。髌骨切除术并非解决办法。
