Hartford J M, Goodman S B, Schurman D J, Knoblick G
Stanford University Medical Center, California 94305, USA.
J Arthroplasty. 1998 Jun;13(4):380-7. doi: 10.1016/s0883-5403(98)90002-x.
The condylar constrained total knee arthroplasty was performed on 29 patients undergoing 33 procedures and were reviewed clinically and radiographically at an average follow-up of 5 years (range, 2-10 years). There were 21 women and 8 men. The average age at the time of surgery was 70 years (range, 32-84). Of the 16 knees that were revision total knee arthroplasties, 8 had a previous infected total knee arthroplasty, and 17 knees had severe deformities requiring the use of the condylar constrained prosthesis. The patients were rated according to the Knee Society clinical and radiological evaluation protocol. Measurements of femoral and tibial component position were obtained as well as femoral tibial angle, patella position, and cement bone radiolucencies. All clinical measurements were made by an independent physical therapist. Clinical results revealed an improvement from an average preoperative knee score of 38 points to an average postoperative score of 86 points. The clinical results for 19 (58%) knees were excellent, 8 (24%) had a good result, 1 (3%) was fair, 2 (6%) were poor, and 3 (9%) were failures. The patients' average functional levels increased from 24 to 58. The final average flexion was 96 degrees. Three knees have been revised (9%). One was revised for recurrent infection, one for periprosthetic fracture, and one for mechanical loosening of the tibial component. There were no other knees with evidence of radiologic loosening. We conclude that the condylar constrained total knee prosthesis provides an acceptable solution for revision and complex primary total knee replacements at an intermediate follow-up term of 5 years.
对29例患者实施了33次髁限制型全膝关节置换术，并在平均5年（范围2 - 10年）的随访期进行了临床和影像学检查。其中女性21例，男性8例。手术时的平均年龄为70岁（范围32 - 84岁）。在16例翻修全膝关节置换术中，8例曾有感染性全膝关节置换术史，17例膝关节有严重畸形，需要使用髁限制型假体。根据膝关节协会临床和放射学评估方案对患者进行评分。获得了股骨和胫骨假体位置的测量数据以及股胫角、髌骨位置和骨水泥 - 骨界面的透亮线情况。所有临床测量均由独立的物理治疗师进行。临床结果显示，术前膝关节平均评分为38分，术后平均评分为86分。19例（58%）膝关节临床结果为优，8例（24%）为良，1例（3%）为中，2例（6%）为差，3例（9%）为失败。患者的平均功能水平从24提高到58。最终平均屈曲度为96度。有3例膝关节进行了翻修（9%）。1例因反复感染翻修，1例因假体周围骨折翻修，1例因胫骨假体机械性松动翻修。没有其他膝关节有影像学松动的证据。我们得出结论，在5年的中期随访期，髁限制型全膝关节假体为翻修和复杂的初次全膝关节置换提供了可接受的解决方案。
