Alumina versus polyethylene in total knee arthroplasty.
Alumina versus polyethylene in total knee arthroplasty.
复制标题
全膝关节置换术中的氧化铝与聚乙烯。
DOI：
10.1097/00003086-199209000-00012
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发表时间：
1992
影响因子：
4.2
通讯作者：
S. Kushitani
中科院分区：
文献类型：
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作者：
H. Oonishi;Mitsushi Aono;Norikazu Murata;S. Kushitani
非骨水泥氧化铝全膝关节假体，在与骨骼接触的部分使用氧化铝，在滑动部分使用氧化铝和超高相对分子质量聚乙烯(UHMWPE)的组合，被称为全髁突。1982年1月至1985年2月，对137例患者进行了氧化铝全膝关节置换术，其中类风湿性关节炎103例，骨关节病34例。随访时间分别为7年11个月和4年10个月。在随访评估中，108名患者可进行临床和X线片检查，随访率为79%。随访时，67个关节(62%)完全无疼痛，28个关节(26%)负重轻微疼痛。RA患者步行能力恢复中等，OA患者步行能力恢复明显。类风湿关节炎84个膝关节中，14个膝关节内固定，1个膝关节松解。72枚非骨水泥种植体中，胫骨远端移位55例，股骨松动1例，股骨近端移位31例，股骨松动6例。OA组21个无骨水泥膝关节胫骨移位17个，股骨移位10个，松动2个。扫描电子显微镜(SEM)观察到超高相对分子质量聚乙烯(UHMWPE)在胫骨钢板表面的光滑和抛光。氧化铝在滑动部分远优于金属，但对于与骨骼接触的部分来说，氧化铝并不总是最好的。为了解决这些问题，在钛合金和氧化铝种植体的锚固部分进行了珠子覆盖和羟基磷灰石涂层，以实现非骨水泥固定。骨水泥固定采用“界面生物活性骨水泥技术”，将羟基磷灰石颗粒嵌入骨与骨水泥之间。
The cementless alumina total knee prosthesis, which uses alumina in the portions coming in contact with the bone and a combination of alumina and ultra-high molecular-weight polyethylene (UHMWPE) in the sliding portions, is referred to as a total condylar. Alumina total knee arthroplasty was performed on 137 patients, including 103 rheumatoid arthritis (RA) and 34 osteoarthrosis (OA) patients, from January 1982 to February 1985. The follow-up period was seven years 11 months and four years ten months, respectively. At follow-up evaluation, 108 patients were available for clinical and roentgenographic examinations, amounting to a 79% follow-up rate. At follow-up examination, 67 joints (62%) were completely pain free and 28 joints (26%) caused slight pain on bearing weight. Walking ability was recovered moderately in RA and markedly in OA. In RA, 14 of 84 knees were cemented and one knee was treated with loosening. Of 72 cementless implantations, 55 sustained displacing distally and one sustained loosening in the tibia, whereas 31 sustained displacing proximally and six sustained loosening in the femur. In OA, 21 cementless knees had 17 displacings in the tibia, and ten displacings and two loosenings in the femur. Scanning electron microscopy (SEM) observation of the UHMWPE surface in tibial plates revealed smoothing and burnishing. Alumina is far superior to metal for the sliding part, although it is not always best for the portion in contact with the bone. To resolve these problems, for cementless fixation, anchoring portions of Ti alloy and alumina implants were covered with beads and coated with hydroxyapatite. For cement fixation, "the interface bioactive bone cement technique" interposing hydroxyapatite granules between bone and cement was performed.