Meister K, Cobb A, Bentley G
University College London and the Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, England.
J Bone Joint Surg Br. 1998 Nov;80(6):965-70. doi: 10.1302/0301-620x.80b6.8194.
Between 1989 and 1993 we implanted a matrix support prosthesis made of carbon fibre for the treatment of chronic painful articular defects of the patella in 27 patients. The mean period of follow-up was 33 months (11 to 54) with clinical and arthroscopic evaluation of the implant. Overall, there were four excellent, three good, seven fair and 13 poor results. Nine patients subsequently had a patellectomy for persistent pain at a mean of 27 months after surgery (14 to 47). The mean visual analogue pain scores in those who retained their patella were 7.6 before operation and 5.5 at the time of the latest follow-up. Patient satisfaction for the entire group was 41%. There appeared to be good incorporation of the prosthesis and a satisfactory ingrowth of fibrocartilage, but the poor results in 48% and low patient satisfaction discourage us from recommending the procedure for lesions of the articular cartilage of the patella. The consistent seeding of the joint with carbon-fibre debris and a histiocytic giant-cell reaction in the synovium are also a cause for concern.
1989年至1993年间，我们为27例慢性疼痛性髌骨关节缺损患者植入了由碳纤维制成的基质支撑假体。平均随访期为33个月（11至54个月），对植入物进行了临床和关节镜评估。总体而言，结果为优4例、良3例、可7例、差13例。9例患者随后因持续疼痛在术后平均27个月（14至47个月）行髌骨切除术。保留髌骨的患者术前视觉模拟疼痛评分平均为7.6，最近一次随访时为5.5。整个组的患者满意度为41%。假体似乎有良好的整合以及纤维软骨的满意长入，但48%的差结果和低患者满意度使我们不推荐该手术用于髌骨关节软骨损伤。关节内持续出现碳纤维碎片以及滑膜中的组织细胞性巨细胞反应也是令人担忧的原因。
