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类风湿性关节炎患者使用限制性髁膝关节假体的中期临床结果。

Mid-term clinical outcome of constrained condylar knee prosthesis for patients with rheumatoid arthritis.

作者信息

Fujiwara Toshifumi, Fujimura Kenjiro, Hamai Satoshi, Kamura Satoshi, Nakashima Yasuharu, Miyahara Hisaaki

机构信息

a Department of Rheumatology & Orthopaedic Surgery , Kyushu Medical Center , Fukuoka , Japan.

b Department of Orthopaedic Surgery , Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan.

出版信息

Mod Rheumatol. 2019 Jul;29(4):596-601. doi: 10.1080/14397595.2018.1486954. Epub 2018 Jul 23.

Abstract

This study retrospectively investigated the mid-term outcome of Legacy constrained condylar knee (LCCK) prosthesis in patients with rheumatoid arthritis (RA) having severe varus/valgus deformity, instability, and/or bone loss. Between January 2000 and December 2015, LCCK prostheses had been performed in 32 knees of 25 patients with RA, and 23 knees of 17 patients of the postoperative follow-up minimum 2 years were analyzed in this study (Primary: 14 knees, Revision: 9 knees). The average of follow-up duration was 6.9 ± 2.7 years, all were female, and the average of age and RA duration at the surgery was 59.0 ± 9.5 years and 26.6 ± 13.5 years, respectively. Clinical result was analyzed by Knee Society Score (KSS) knee and function at preoperative time and final visit. Imaging outcome was investigated by femoral tibial angle (FTA), four component alignment angles, and radiolucent line at pre-/postoperative time. KSS knee/function scores and radiographic FTAs were improved after operation. Radiolucent lines around components were seen in 17 knees (73.9%), of which only one knee (4.3%) has shown aseptic loosening. The seven-year Kaplan-Meier survivorship analysis resulted in 91.7%. LCCK prosthesis in RA patients was achieved to the excellent mid-term clinical and radiographic result.

摘要

本研究回顾性调查了传统受限髁型膝关节(LCCK)假体在患有严重内翻/外翻畸形、不稳定和/或骨质流失的类风湿关节炎(RA)患者中的中期疗效。2000年1月至2015年12月期间,对25例RA患者的32个膝关节进行了LCCK假体置换,本研究分析了17例患者术后至少随访2年的23个膝关节(初次手术:14个膝关节,翻修手术:9个膝关节)。平均随访时间为6.9±2.7年,均为女性,手术时的平均年龄和RA病程分别为59.0±9.5岁和26.6±13.5年。通过膝关节协会评分(KSS)的膝关节和功能评分在术前及末次随访时分析临床结果。通过术前/术后的股胫角(FTA)、四组件对线角度和透亮线来研究影像学结果。术后KSS膝关节/功能评分及影像学FTA均得到改善。17个膝关节(73.9%)出现假体周围透亮线,其中仅1个膝关节(4.3%)出现无菌性松动。七年的Kaplan-Meier生存率分析结果为91.7%。RA患者使用LCCK假体取得了优异的中期临床和影像学结果。

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