Early failures among 7,174 primary total knee replacements -: A follow-up study from the Norwegian Arthroplasty Register 1994-2000
Early failures among 7,174 primary total knee replacements -: A follow-up study from the Norwegian Arthroplasty Register 1994-2000
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DOI：
10.1080/000164702753671678
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发表时间：
2002-04-01
期刊：
影响因子：
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通讯作者：
Havelin, LI
中科院分区：
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作者：
Furnes, O;Espehaug, B;Havelin, LI
我们研究了挪威关节成形术登记处报告的 1994 年至 2000 年间进行的初次全膝关节置换术 (TKR)。使用 Cox 多元回归模型来评估假体品牌之间的生存差异、固定类型以及是否重新修复髌骨。 1999 年，挪威的膝关节假体手术发生率为每 100,000 名居民 35 例。 87% 的膝盖使用水泥固定，10% 为混合型，2% 为非骨水泥固定。 65% 的膝盖使用了双室（未重修髌骨）假体。以所有修正为终点，骨水泥三室假体品牌之间的 5 年生存率没有显着差异：AGC 97% (n 279)、Duracon 99% (n 101)、Genesis 195% (n 654)、Kinemax 98% (n 213) 和 Tricon 96% (n 454)。双室 LCS 假体的 5 年生存率为 97% (n 476)。 LCS 膝关节的半月板轴承类型对生存率没有影响。以所有原因翻修为终点的生存率显示，固定类型或双室或三室假体之间没有差异。疼痛本身就是骨水泥双室假体翻修的最常见原因。骨水泥双室假体因疼痛而进行翻修的风险比骨水泥三室假体高 5.7 倍 (p < 0.001)，但翻修主要涉及插入髌骨假体。三室假体因感染而进行翻修的风险比双室假体高 2.5 倍 (p = 0.03)。年轻（<60岁）和骨折后后遗症增加了翻修风险。6个最常用的骨水泥三间室膝关节假体品牌的5年生存率在95%到99%之间变化，但差异无统计学意义。由于双室膝关节疼痛而进行的翻修次数多于三室膝关节。然而，在三室膝关节中，由于感染而进行了更多的修正。相对少数使用非骨水泥和混合植入物的患者与骨水泥膝关节假体相比，结果没有任何改善。
We studied primary total knee replacements (TKRs), reported to the Norwegian Arthroplasty Register, operated on between 1994 and 2000. A Cox multiple regression model was used to evaluate differences in survival among the prosthesis brands, their types of fixation, and whether or not the patella was resurfaced.In Norway in 1999, the incidence of knee prosthesis operations was 35 per 100,000 inhabitants. Cement was used as fixation in 87% of the knees, 10% were hybrid and 2% uncemented implants. Bicompartmental (not resurfaced patella) prostheses were used in 65% of the knees. With all revisions as endpoint, no statistically significant differences in the 5-year survival were found among the cemented tricompartmental prostheses brands: AGC 97% (n 279), Duracon 99% (n 101), Genesis 195% (n 654), Kinemax 98% (n 213) and Tricon 96% (n 454). The bicompartmental LCS prostheses had a 5-year survival of 97% (n 476). The type of meniscal bearing in LCS knees had no effect on survival.Survival with revision for all causes as endpoint showed no differences among types of fixation, or bi- or tricompartmental prostheses. Pain alone was the commonest reason for revision of cemented bicompartmental prostheses. The risk of revision because of pain was 5.7 times higher (p < 0.001) in cemented bicompartmental prostheses than cemented tricompartmental ones, but the revisions mainly involved insertion of a patellar component. In tricompartmental prostheses the risk of revision because of infection was 2.5 times higher than in bicompartmental ones (p = 0.03). Young age (< 60) and the sequelae after a fracture increased the risk of revision.The 5-year survival of the 6 most used cemented tricompartmental knee prostheses brands varied between 95% and 99%, but the differences were not statistically significant. There were more revisions because of pain in bicompartmental than in tricompartmental knees. In tricompartmental knees, however, there were more revisions because of an infection. The relatively few patients with uncemented and hybrid implants showed no improvements in results compared to cemented knee prostheses.