活动衬垫膝关节假体行关节置换的中长期报告

Long term clinical outcome of mobile bearing knee prosthesis

目的对应用可活动衬垫膝关节假体行关节置换术后的临床中长期效果进行评价。方法对我院1997年11月-2007年12月应用可活动衬垫膝关节假体行膝关节表面置换的住院患者746膝（653例）进行临床及X线随访，根据HSS评分标准进行临床评价。结果HSS评分从术前平均51．2分提高到术后平均92．1分，优良率达92．3％。活动范围从术前平均伸-7．5°、屈64．3°到术后平均伸-1．1°、屈103．5°。术后12例感染，5例假体周围骨折，其他未发现有骨溶解、假体松动或活动衬垫脱位等并发症。结论活动衬垫膝关节增加了股骨与聚乙烯衬垫之间的匹配，减少了接触应力和聚乙烯的磨损，其术后短期及中长期临床效果令人满意。

Objective To evaluate the long term clinical outcome of mobile bearing knee prosthesis in TKA. Methods A total of 746 TXA（653 patients） using mobile bearing,knee prosthesis were followed up from Nov. 1997 to Dec. 2007. X-ray films and HSS knee scores were used to evaluate the results. Results The mean HSS score was 51.2 before operation and 92.1 after operation. The ROM was extension/flexion （ - 7.5°/64.3°） before operation and extension/flexion（ - 1.1°/103.5°） after operation. A total of 12 cases of septic loosening and 5 cases of femoral fracture were found. The complications such as osteolysis around the prosthesis, prosthetic loosening and dislocation of meniscus bearings were not found by X-ray examination. Conclusions The design of the mobile bearing knee can reduce the surface and subsurface stress of the bearing surfaces and at the bone-implant interfaces by maximizing the conformity of the tibial and femoral components allowing mobility of the loosening of the components. It has advantages in kinematics and wear experiments and has good long-term clinical outcome.