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Long-term outcome of low contact stress total knee arthroplasty with different mobile bearing designs

机译:低接触应力全膝关节置换术与不同移动轴承设计的长期结果

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摘要

Purpose: to evaluate the differences in clinical outcome and survivorship of three different mobile bearings for total knee arthroplasty.udMethods: a retrospective study was conducted in 60 patients (53 females, 7 males, mean age: 68 years and 5 months) each submitted to total knee replacement using one of the three different mobile bearings of the LCS system (Depuy Johnson & Johnson, Warsaw, IN). The diagnosis was knee osteoarthritis in 57 cases and rheumatoid arthritis in three cases. Three different groups of 20 cases each were identified: total knee arthroplasties with mobile menisci (group 1); total knee arthroplasties with the rotating platform (group 2); and total knee arthroplasties with the anteroposterior glide platform (group 3). As regards the component fixation, 33 implants were cementless, three were cemented, and in 24 only the tibial component was cemented. The patella was not replaced.udResults: although the duration of follow-up differed between the three groups, the clinical and radiological results at final follow-up showed no revision of femoral and/or tibial components for mechanical or septic reasons, and no signs of impending failure. One meniscal bearing, showing polyethylene wear after 17 years, was successfully replaced.udConclusions: the present retrospective study confirmed the long-term effectiveness of knee implants with mobile bearings, in which the congruity of the surfaces makes it possible to overcome the problem of high contact stresses that may result in polyethylene wear and osteolysis; at the same time, these implants eliminate constraint forces thereby reducing the risk of mechanical loosening.udLevel of evidence: Level III, retrospective comparative study.
机译:目的:评估三种不同的全膝关节置换术活动轴承在临床结果和生存率方面的差异。 ud方法:对60例患者(53例女性,7例男性,平均年龄:68岁和5个月)进行了回顾性研究使用LCS系统的三种不同移动轴承之一(印第安纳州华沙的Depuy Johnson&Johnson)进行全膝关节置换。诊断为膝骨关节炎57例,类风湿关节炎3例。确定了三个不同的组,每组20例:半月板活动性半月板全膝关节置换术(第1组);旋转平台进行全膝关节置换术(第2组);和滑行前后平台的全膝关节置换术(第3组)。在部件固定方面,33颗种植体是非骨水泥的,三颗是骨水泥,而在24颗中只有胫骨骨是骨水泥。 ud结果:尽管三组的随访时间不同,但最终随访的临床和放射学结果显示,由于机械或脓毒症原因,股骨和/或胫骨组件未发生任何改变,且无即将发生故障的迹象。结论:本回顾性研究证实了带有活动轴承的膝关节植入物的长期有效性,其中表面的一致性使克服这一问题成为可能。高接触应力可能导致聚乙烯磨损和骨溶解;同时,这些植入物消除了约束力,从而降低了机械松动的风险。 ud证据级别:III级,回顾性比较研究。

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