背景:多孔钽金属在人工髋膝关节翻修中提供有效的初始稳定性及优越的骨整合已获得公认,然而非骨水泥多孔钽金属胫骨平台在初次人工全膝关节置换的应用仍存在争论.有学者怀疑膝关节置换的非骨水泥固定方式影响假体寿命,甚至软组织易与多孔金属粘连而导致术后膝关节僵硬或疼痛.目的:对比采用非骨水泥多孔钽金属胫骨平台与传统骨水泥平台进行全膝关节置换的短期疗效.方法:选择使用非骨水泥多孔钽金属胫骨平台接受初次单侧人工膝关节置换的患者14例,并随访同期使用传统骨水泥平台进行初次全膝关节置换的患者14例.全部28例患者术前均为终末期骨关节炎.对患者进行临床及影像学随访,随访时间1-3年.结果与结论:①随访期间2组未出现再次手术病例;②2组患者术后美国膝关节协会膝评分、美国膝关节协会功能评分、膝关节屈伸范围及末次随访股胫夹角对比,差异均无显著性意义(P > 0.05);③2组影像学随访均未发现胫骨侧假体的无菌性松动,胫骨平台下沉及移位;④结果表明,人工全膝关节置换中多孔钽金属胫骨平台的使用能够获得与传统骨水泥平台相近的临床及影像学早期结果,而远期假体生存率需进一步随访.%BACKGROUND: Porous tantalum metal has been recognized for its effective initial stability and superior bone consolidation in artificial hip/knee reversions. However, the application of the trabecular monoblock metal tibial components in the primary total knee arthroplasty (TKA) still remains controversial. Some scholars think that the non-bone cement fixation of TKA affects the life of prosthesis, and even the soft tissue is easy to be adhered with the porous metal, which results in the stiffness or pain of the knee joint after surgery. OBJECTIVE: To compare the short-term clinical efficacy of the trabecular monoblock metal and conventional cemented tibial components in TKA. METHODS: Fourteen patients undergoing unilateral TKA with trabecular monoblock metal tibial components non-bone cement porous tantalum tibial platform, and 14 patients with TKA using conventional cemented tibial components were enrolled. All patients suffered from advanced knee osteoarthritis, and were followed up for 1-3 years to correct the clinical and radiological data. RESULTS AND CONCLUSION: (1) No case underwent secondary surgery. (2) The clinical and function American Knee Society Score scales, the range of motion of the knee during flexion and extension, and femorotibial angle at last follow-up did not differ significantly between two groups (P > 0.05). (3) Radiological results revealed no aseptic loosening of the prosthesis, or subsidence and displacement of the tibial platform during follow-up. (4) These findings suggest that the application of trabecular monoblock metal tibial components in TKA can obtain similar clinical and radiological outcomes with the conventional cemented tibial components, but the long-term survival rate of the prosthesis still needs to be further explored.
展开▼
