Distal femoral arthroplasty using custom-made prostheses. The first 218 cases.
Distal femoral arthroplasty using custom-made prostheses. The first 218 cases.
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DOI：
10.1016/s0883-5403(06)80087-2
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发表时间：
1993-06-01
期刊：
影响因子：
--
通讯作者：
Walker, P S
中科院分区：
文献类型：
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作者：
Unwin, P S;Cobb, J P;Walker, P S
回顾了218例采用骨水泥髓内斯坦莫尔大块股骨远端关节置换术与单轴铰链膝关节保肢的病例，平均随访58个月，最长251个月。松动（5%）、局部复发（4%）、髓内柄骨折（3%）和感染（2%）是需要手术干预的主要并发症。除1例外，所有病例均通过插入第二个大块置换物治疗松动和植入物断裂。所有复发和感染的情况下，除了一个需要截肢。生存率分析显示，这些早期假体中的一个存活10年的总概率为65%，存活20年的总概率为53%。对于骨肿瘤病例，10年生存率为68%（不包括复发），初次膝关节置换病例为32%，其他骨病加创伤病例为86%，翻修大型假体病例为53%。得出的结论是，这种类型的股骨远端关节成形术提供了良好的中期结果，但在长期显示出一些缺陷，特别是在年轻患者中。
The first 218 cases of limb salvage using cemented intramedullary Stanmore massive distal femoral arthroplasties with a single-axis hinged knee, followed for an average of 58 months with a maximum of 251 months, were reviewed. Loosening (5%), local recurrence (4%), intramedullary stem fracture (3%), and infection (2%) were the major complications requiring surgical intervention. Loosening and implant fracture were treated by the insertion of a second massive replacement in all but one case. All recurrences and all but one infected case required amputation. Survivorship analysis showed that the overall probability of one of these early prostheses surviving for 10 years was 65%, and for 20 years it was 53%. For cases of bone tumor, the probability of surviving for 10 years was 68% (not including recurrence), for primary knee replacement cases it was 32%, for other bony diseases plus trauma it was 86%, and for cases of revised massive prostheses it was 53%. It was concluded that this type of distal femoral arthroplasty provided good medium-term results, but showed some deficiencies in the long term, particularly in younger patients.