Sagittal laxity in vivo after total knee arthroplasty

Introduction A stress arthrometry study of 77 knees undergoing total knee arthroplasty was performed to determine the difference in anteroposterior (AP) laxity between posterior cruciate ligament (PCL)-retaining (PCLR) and PCL-substituting (PCLS) prostheses using the Genesis I TKA.Materials and methods Fifty-three knees had PCLR and 24 had PCLS prostheses. The selected patients had successful arthroplasties after a minimum follow-up of 5 years. AP laxity was measured with a KT-2000 arthrometer (Medmetric, San Diego, CA, USA) using standard protocols.Results At 30° of flexion, there was no statistical difference in anterior (PCLR: 4.7 mm, PCLS: 4.5 mm), posterior (PCLR: 1.1 mm, PCLS: 0.7 mm), or total (PCLR: 5.8 mm, PCLS: 5.3 mm) displacement. At 75°, significant differences were seen in both anterior (PCLR: 3.3 mm, PCLS: 2.3 mm) and total (PCLR: 4.8 mm, PCLS: 3.4 mm) displacement (p=0.001 and p=0.009, respectively), although there was no statistical difference in posterior displacement (PCLR: 1.5 mm, PCLS: 1.1 mm).Conclusion The above values are considered the suitable degree of AP laxity in total knee arthroplasty for a satisfactory clinical outcome 5–9 years after surgery. The PCL in a PCLR prosthesis and the central tibial spine and femoral cam in a PCLS prosthesis might play comparable roles in determining the laxity in the posterior direction in these prostheses.     

Effect of soft tissue tension on measurements of coronal laxity in mobile-bearing total knee arthroplasty

Background The purpose of this study was to determine the effect of intraoperative coronal laxity in total knee arthroplasty on the postoperative condition. Methods We conducted stress arthrometric studies using a Telos arthrometer on 40 knees in 36 patients. Both posterior cruciate ligament-retaining (PCLR) prostheses and posterior cruciate-sacrificing (PCLS) prostheses were placed in 20 knees respectively. All of the TKA procedures were judged clinically successful (Hospital for Special Surgery scores: PCLR 92 ± 3 points, PCLS 91 ± 4 points). Laxities were measured under spinal anesthesia (immediately postoperatively) and 6 months postoperatively. Results PCLR prostheses had an average of 2.9° ± 1.8° and 3.0° ± 1.2° in abduction and 4.4° ± 2.8° and 3.6° ± 1.5° in adduction under anesthesia and the postoperative condition. PCLS prostheses had average laxities of 3.8° ± 1.4° and 3.5° ± 0.9° in abduction and 4.6° ± 3.8° and 4.0° ± 1.7° in adduction. There were no significant differences between them. Conclusions The findings suggest that surgeons should emphasize the achievement of suitable laxity under anesthesia to ensure the success of total knee arthroplasty.     

Range of motion during the perioperative period in total knee arthroplasty

INTRODUCTION: This study focused on the change in the range of motion (ROM) during the perioperative period, i.e., the preoperative and intraoperative ROM, and that on discharge, and compared the difference between posterior cruciate ligament-retaining (PCLR) and -sacrificing (PCLS) prostheses. MATERIALS AND METHODS: In this prospectively randomized study, we compared the changes in the ROM in PCLR (n = 50) and PCLS (n = 50) total knee arthroplasties. RESULTS: The mean flexion in PCLR prostheses was 130.0 degrees preoperatively, 120.0 degrees intraoperatively, and 105.0 degrees at discharge, and 125.0 degrees , 120.0 degrees , and 100.0 degrees , respectively, in PCLS. The designs did not differ statistically in each period (P > 0.05). Both designs showed significant correlations between the preoperative and intraoperative ROM, and between the preoperative and discharge ROM. Only the PCLS showed a significant correlation between the intraoperative and discharge ROM, and a significant difference was observed in correlation of rank coefficient between the two prostheses (P < 0.001). CONCLUSIONS: The PCLS design has an advantage in rehabilitation planning because of the predictable changes in the ROM during the perioperative period, although the acquired average ROM at discharge did not differ statistically.     

Effect of flexion angle on coronal laxity in patients with mobile-bearing total knee arthroplasty prostheses

Proper soft tissue tension is one of the important factors in mobile-bearing total knee arthroplasty (TKA). We evaluated varus/valgus laxities, particularly at flexion, which is a key factor in reducing the risk of subluxation and dislocation of bearings to assess the effect that the flexion angle and the presence or absence of the posterior cruciate ligament (PCL) have on laxity in patients with low-contact stress (LCS) prostheses of the PCL-retaining (24 patients, 24 knees) and PCL-sacrificing (24 patients, 24 knees) type designs during extension and flexion. Both types of prosthesis had about 4° laxity at extension and 3° at flexion. PCL-retaining prostheses had significantly less laxity at flexion than at extension (P = 0.0004 in varus, P = 0.0043 in valgus). For good clinical outcomes following TKA, 3°–4° laxity in the varus and valgus orientations is recommended. In addition, the PCL might be involved in flexion and could affect varus/valgus laxity in PCL-retaining prostheses.     

In vivo laxity of low contact stress mobile-bearing prostheses

A stress arthrometric study was done on 60 knees in 54 patients with total knee arthroplasties using a Telos arthrometer, to determine anteroposterior and abduction and adduction laxity and to evaluate the relationship between laxity and retention of the posterior cruciate ligament using low contact stress mobile-bearing prostheses. Thirty knees had posterior cruciate ligament-retaining and 30 had posterior cruciate ligament-sacrificing prostheses. The selected patients had successful knee arthroplasty 6 months previously. Anteroposterior displacement was measured at 30 degree and 90 degree flexion; there were no statistically significant differences between the posterior cruciate ligament-retaining (10.5 mm at 30 degree, 9.3 mm at 90 degree) and posterior cuciate ligament-sacrificing (9.8 mm at 30 degree, 9.7 mm at 90 degree) groups. Abduction and adduction were between 0 degree and 20 degree flexion, there were no significant differences between the two groups. Because all the patients in this study had good clinical results, approximately 10 mm anteroposterior displacement and 4 degree laxity in the coronal direction are considered favorable in low contact stress mobile-bearing prostheses of both designs.     

Knee stability in posterior cruciate ligament retaining total knee arthroplasty

Anteroposterior knee laxity was evaluated in 14 patients (19 knees) who had posterior cruciate ligament retaining total knee arthroplasty using the Miller Galante I prosthesis. The followup ranged from 87 to 118 months (average, 105.9 months), and the measurements were done using the KT-2000 arthrometer. The mean anteroposterior displacement with the knees with Miller Galante I prostheses was 10.1 mm at 30 degrees flexion and 8.1 mm at 75 degrees flexion. In the 15 knees with Miller Galante I prostheses with flexion greater than 90 degrees, seven had less stability at 75 degrees than at 30 degrees flexion. These knees were considered to have a nonfunctional posterior cruciate ligament, and they had a worse Knee Society score (81.1) than did the other eight knees with Miller Galante I prostheses (89.9). There were four knees in which the flexion was less than 90 degrees. In this study, approximately half of the knees with posterior cruciate ligament retaining total knee arthroplasty did not have good anteroposterior stability in flexion an average of 9 years after surgery.     

Treatment of infected knee arthroplasty

Forty-eight patients with 51 infected knee arthroplasties were treated at the authors' institution between 1973 and 1986 and followed for 5.5 (range, 0-14) years. Six methods to treat the infections were employed: antibiotics only, soft-tissue surgery, removal of the prosthesis, revision arthroplasty, arthrodesis, and amputation. Failure of the initial surgical treatment led to second revision surgery in 20 patients. At the follow-up examination, three patients (five knees) had died from septic complications and two patients had had above-knee amputation. Two of 32 patients had been successfully treated with antibiotics with no additional surgery. Four patients had successful soft-tissue surgery. Following removal of the prosthesis, the infection healed in four patients. In 12 of 19 patients (13 knees) with revision arthroplasty the infection healed, but only seven of these had functioning prostheses. The infection healed in all but one of the 21 patients with arthrodeses, and all but two were fused. Infected compartmental prostheses with good bone stock can be treated with an exchange arthroplasty using a two-stage procedure with tricompartmental revision prostheses. Otherwise, an arthrodesis using a two-stage procedure is recommended for the treatment of infected knee arthroplasty.     

Clinical and radiographic results of the total condylar III and constrained condylar total knee arthroplasty

The Total Condylar III (Johnson and Johnson, Braintree, MA) and Constrained Condylar (Zimmer, Warsaw, IN) knee prostheses are nonlinked, semi-constrained prosthetic alternatives to rigid or rotating hinge prostheses for use in complex knee reconstructions. Forty-six Total Condylar III or Constrained Condylar prostheses were implanted with cement in 36 patients and followed for a mean of 5 years (range, 2–9 years). There were 25 primary total knee arthroplasties and 21 revision total knee arthroplasties. The knees were evaluated using The Hospital for Special Surgery 100-point knee rating system. Overall, 40 knees (87%) had a good or excellent clinical result, 2 knees (4%) had a fair result, and 4 knees (9%) had a poor result. There was one revision for loosening of a cemented, nonmodular Constrained Condylar prosthesis, and one knee had a debridement for a late, metastatic infection, but the components were retained. There were no mechanical failures in those knees that were primary arthroplasties, but two mechanical failures occurred in those knees that were revision arthroplasties. Radiographic review showed one asymptomatic loosening of a Constrained Condylar tibial component with an uncemented press-fit stem, and only 8 knees had scattered nonprogressive tibial bone—cement radiolucent lines. The Total Condylar III and Constrained Condylar semiconstrained prostheses are successful when used in complex knee reconstructions.     

Clinical Outcome of Total Knee Arthroplasty With Medial Pivot Prosthesis : A Comparative Study Between the Cruciate Retaining and Sacrificing

The purpose of this study is to evaluate results after total knee arthroplasty using a medial pivot prosthesis with the posterior cruciate ligament (PCL)-retaining and PCL-sacrificing techniques. The PCL was retained in 67 knees and sacrificed in 70 knees. The mean Knee Society knee score increased from 59.6 before surgery to 91.5 at the last follow-up, and the mean function score increased from 53.6 to 85.4. The mean preoperative femorotibial angle was varus 4.1°, which corrected to valgus 5.8° after surgery. The increased knee and function score did not vary significantly between the cruciate-retaining and cruciate-sacrificing groups (P > .108), nor did the mean preoperative and postoperative femorotibial angle (P > .140). The clinical results of total knee arthroplasty with a medial pivot prosthesis were satisfactory, whether the PCL was retained or sacrificed.     

Osteolytic indicators found in total knee arthroplasty synovial fluid aspirates

Interleukin-1beta and tartrate resistant acid phosphatase concentrations in synovial fluid aspirates were examined to determine if they could be used as indicators of increased synovial inflammation and an osteolytic reaction in patients having total knee arthroplasty. Synovial aspirates were obtained from seven patients with severely osteoarthritic knees that were scheduled for primary total knee arthroplasty and from 20 patients with knees scheduled for total knee arthroplasty revision. Eleven of the revision cases involved titanium alloy prostheses and nine involved cobalt chrome alloy prostheses. The interleukin-1beta and tartrate resistant acid phosphatase concentrations were obtained and compared between the group having primary total knee arthroplasty and the group having revision total knee arthroplasty. The knees having revision surgery had higher concentrations of interleukin-1beta and tartrate resistant acid phosphatase than did the knees having primary total knee arthroplasty. These results indicate a greater inflammatory and osteolytic response in knees having revision surgery. Although the osteoarthritic knees and the knees needing revision surgery in this study are considered to have an inflammatory state, it was only after total knee arthroplasty when particulate wear debris would be present that appreciable concentrations of interleukin-1beta and tartrate resistant acid phosphatase were produced.     

Early range of motion of the scorpio non-restrictive geometry cruciate-retaining total knee system

Flexion following total knee arthroplasty in the US population generally falls between 100° and 120°. Because of these relatively low flexion arcs, total knee arthroplasty prosthetic designs emerged allowing “high flexion” (≥125°). We hypothesized that a high-flexion implant design, Scorpio Non-Restrictive Geometry cruciate-retaining knee prosthesis, would allow clinical early maximum flexion of at least 125°. A prospective observational cohort study enrolled 87 unselected patients (94 knees) evaluated preoperation and 3 months and 1 year postoperation for clinical flexion, arc of motion, and Knee Society scores. At 1 year, 67% of knees had improved flexion and 23% achieved flexion of at least 125°. Clinically, flexion improved by 6.9° and total arc of motion improved by 10.6° from preoperation to 1-year postoperation. Although this high-flexion design allows increased flexion, many patients fail to achieve flexion of at least 125°.     

Posterior Cruciate Ligament Retention or Substitution During Total Knee Arthroplasty Does Not Affect Long-Term Bone Mineral Density or Quality

Background

Physical activity is recognized as one of the factors that influence bone mineral density (BMD) and bone quality after total knee arthroplasty (TKA). According to biomechanical analyses after posterior cruciate ligament (PCL) retaining (PCLR) and substituting (PCLS) TKA, each implant design has different kinematics and kinetics. The purposes of this study were: (1) to perform within-patient comparisons of the midterm and long-term effects of PCL retention in mobile-bearing TKA on proximal femur and tibia BMD and calcaneus bone quality measured using ultrasound and (2) to identify correlations between them.

Revision total knee arthroplasty with a cemented posterior-stabilized or constrained condylar prosthesis: A minimum 3-year and average 5-year follow-up study

The results of 57 revision total knee arthroplasties performed for aseptic failure between 1984 and 1992 with a cemented posterior-stabilized or constrained condylar prosthesis were reviewed at follow-up examinations at a minimum of 36 and an average of 62 months (range, 36–120 months). The reason for revision was aseptic loosening of 1 or both components in 32 knees (56%), instability in 16 knees (28%), polyethylene wear and osteolysis in 4 knees (7%), supracondylar femur fracture in 2 knees (4%), and a failed allograft, pain, and arthrofibrosis in 1 knee each (5% total). The average age of the patients at the time of the revision was 74 years (range, 38–90), and the original diagnosis for the majority of patients was osteoarthritis (74%). All of the revision prostheses were cemented posterior stabilized or constrained condylar-type implants. Bone deficiencies were grafted with cancellous allograft in contained defects and cortical allograft in noncontained defects. Five knees were reconstructed with allograft-prosthesis composites. The average modified Hospital for Special Surgery knee score improved from 49 to 82 (100 points possible) at final follow-up evaluation (P < 0.001). Seventy-nine percent of knees were graded as good or excellent. Kaplan-Meier survivorship analysis predicted 94% ± 6.2% survival at 40 months and 75% ± 25% at 99 months. There were 4 clinical failures, 3 of which were related to residual instability in patients with a posterior-stabilized prosthesis. Complications (3 knees) were exclusively related to the extensor mechanism. Radiographically, overall knee alignment improved from 0.3° varus to 3.0° valgus. Fifty-six percent of tibial components were placed in slight varus alignment. Radiolucent lines occurred in 33% of knees, but there were no complete or progressive radiolucencies. Radiolucent lines were more prevalent adjacent to press-fit intramedullary femoral stems compared with cemented stems (P < .02), but the difference did not correlate with clinical or radiographic failure. The median bone defect score, as proposed by the Knee Society Committee on Bone Defects, was significantly greater in knees that were revisions of a failed cemented total knee arthroplasty compared with revision of a failed cementless total knee arthroplasty (P = .02) but was not correlated with clinical or radiographic outcome (P> .05).     

The infected knee arthroplasty. A 6-year follow-up of 357 cases

The incidence of deep infection after 12,118 primary knee arthroplasties performed in Sweden from October 1, 1975 through 1985 with a median follow-up of 6 years was 1.7 percent for arthrosis and 4.4 percent for rheumatoid arthritis. Risk factors for infection were large prostheses, postoperative wound-healing complications, rheumatoid arthritis, a prior deep infection, and skin infections. We have analyzed the treatment of 357 knee arthroplasties with a deep infection. Systemic antibiotics alone were primarily used in 225 knees, with healing of the infection in 44 knees, 20 of which had a functioning prosthesis at the final follow-up; the treatment did not compromise later revision surgery. Soft-tissue surgery was used in 154 knees--37 healed, 15 of which had a functioning prosthesis. Resection arthroplasty resulted in healing of the infection in 11 of 22 knees. Revision arthroplasty was performed in 107 knees, with eventual healing of the infection in 81 knees, 36 of which had a functioning prosthesis; there were no differences in the outcome of one-stage and two-stage procedures. Arthrodesis was attempted in 135 knees, with eventual healing of the infection in 120 knees and fusion in 105. Twenty-two patients were amputated. Thus, the infection healed in 315 knees (88 percent), but only 71 (20 percent) recovered with a functioning prosthesis, and 8 patients died of the infection. Attention should therefore focus on prophylactic measures directed towards the soft-tissue problems--by avoiding conflicting skin incisions, by gentle handling of the periarticular soft tissues, by avoiding the use of constrained prostheses and oversized compartmental prostheses, by letting wound healing take priority over motion in knees with compromised soft tissues, and by using prophylactic antibiotic treatment for skin ulcers until these have healed.     

The infected knee arthroplasty: A 6-year follow-up of 357 cases

The incidence of deep infection after 12,118 primary knee arthroplasties performed in Sweden from October 1, 1975 through 1985 with a median follow-up of 6 years was 1.7 percent for arthrosis and 4.4 percent for rheumatoid arthritis. Risk factors for infection were large prostheses, postoperative wound-healing complications, rheumatoid arthritis, a prior deep infection, and skin infections. We have analyzed the treatment of 357 knee arthroplasties with a deep infection. Systemic antibiotics alone were primarily used in 225 knees, with healing of the infection in 44 knees, 20 of which had a functioning prosthesis at the final follow-up; the treatment did not compromise later revision surgery. Soft-tissue surgery was used in 154 knees—37 healed, 15 of which had a functioning prosthesis. Resection arthroplasty resulted in healing of the infection in 11 of 22 knees. Revision arthroplasty was performed in 107 knees, with eventual healing of the infection in 81 knees, 36 of which had a functioning prosthesis; there were no differences in the outcome of one-stage and two-stage procedures. Arthrodesis was attempted in 135 knees, with eventual healing of the infection in 120 knees and fusion in 105. Twenty-two patients were amputated. Thus, the infection healed in 315 knees (88 percent), but only 71 (20 percent) recovered with a functioning prosthesis, and 8 patients died of the infection. Attention should there-fore focus on prophylactic measures directed towards the soft-tissue problems—by avoiding conflicting skin incisions, by gentle handling of the periarticular soft tissues, by avoiding the use of constrained prostheses and oversized compartmental prostheses, by letting wound healing take priority over motion in knees with compromised soft tissues, and by using prophylactic antibiotic treatment for skin ulcers until these have healed.     

The infected knee arthroplasty: A 6-year follow-up of 357 cases

The incidence of deep infection after 12,118 primary knee arthroplasties performed in Sweden from October 1, 1975 through 1985 with a median follow-up of 6 years was 1.7 percent for arthrosis and 4.4 percent for rheumatoid arthritis. Risk factors for infection were large prostheses, postoperative wound-healing complications, rheumatoid arthritis, a prior deep infection, and skin infections. We have analyzed the treatment of 357 knee arthroplasties with a deep infection. Systemic antibiotics alone were primarily used in 225 knees, with healing of the infection in 44 knees, 20 of which had a functioning prosthesis at the final follow-up; the treatment did not compromise later revision surgery. Soft-tissue surgery was used in 154 knees—37 healed, 15 of which had a functioning prosthesis. Resection arthroplasty resulted in healing of the infection in 11 of 22 knees. Revision arthroplasty was performed in 107 knees, with eventual healing of the infection in 81 knees, 36 of which had a functioning prosthesis; there were no differences in the outcome of one-stage and two-stage procedures. Arthrodesis was attempted in 135 knees, with eventual healing of the infection in 120 knees and fusion in 105. Twenty-two patients were amputated. Thus, the infection healed in 315 knees (88 percent), but only 71 (20 percent) recovered with a functioning prosthesis, and 8 patients died of the infection. Attention should there-fore focus on prophylactic measures directed towards the soft-tissue problems—by avoiding conflicting skin incisions, by gentle handling of the periarticular soft tissues, by avoiding the use of constrained prostheses and oversized compartmental prostheses, by letting wound healing take priority over motion in knees with compromised soft tissues, and by using prophylactic antibiotic treatment for skin ulcers until these have healed.     

Tension controlled ligament balanced total knee arthroplasty: 5-year results of a soft tissue orientated surgical technique

Introduction Posterior cruciate ligament (PCL)-retaining prostheses give good outcomes and are commonly used. This retrospective study investigated outcomes from total knee arthroplasty (TKA) using the ligament balancing technique to implant a PCL-retaining knee prosthesis (balanSys™ knee system) with either a mobile or a fixed bearing polyethylene inlay. Materials and methods A retrospective study was performed on patients treated with TKA at one surgical centre between 1997 and 2001. In this period 182 surgeries were performed. Clinical assessments of the implant used the Knee Society Score (KSS). Subjective assessments used visual analogue scale (VAS) for pain and patient satisfaction. The Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) was used to assess pain, stiffness and function of the knee. Radiographic analysis was performed to determine frontal and sagittal alignment and loosening. Results A total of 109 knee implants in 95 patients (26 men; 69 women) were followed up. Seventy-three cases were not available for follow-up due to bad health or death of the patient; 74% of 109 reviewed implants had fixed bearings and 26% had mobile bearings. The mean age at surgery was 72.9 ± 7.35 years (range 54.7–92.4). The mean KSS was 160 ± 28.3 points. The KSS was greater for men and was significantly reduced when another disease was present. The type of bearing, surgical approach, and pre-operative alignment for patients affected by varus or valgus gonarthrosis had no significant impact on KSS and ROM. According to VAS the mean scores for pain and satisfaction were 1.48 (0 = no pain) and 9.2 (10 = very satisfied), respectively. The WOMAC mean scores for pain (87.0), stiffness (82.3) and function (78.6) were high (best outcome score of 100). There were no revisions due to aseptic loosening or wear. Conclusion Total knee arthroplasty performed with a PCL-retaining prosthesis implanted by using a soft tissue oriented surgical technique is a safe procedure and was associated with good results. So far, there were few complications and no need for revision due to aseptic loosening. In addition, most of the patients reported little pain and were satisfied with the outcome. These good outcomes are comparable with other studies reporting on PCL-retaining prostheses.     

Evaluation of the Noiles hinged knee prosthesis. A five-year study of seventeen knees

The Noiles hinged knee prosthesis has been reported to diminish sheer and tensile loading on the cement-bone interface. Theoretically, this should eliminate the complication of loosening, commonly reported in hinged total knee prostheses. We reviewed the cases of all of the patients who have been treated with the Noiles knee prosthesis at our institution. Eighteen knees in fourteen patients were available, seventeen of which were followed for more than five years. Although all of the prostheses did well initially, ten knees in eight patients (56 per cent) had failed by an average of thirty-two months postoperatively. These eight patients included four of the five who weighed more than ninety kilograms and all of those who had had a prior arthroplasty. The failures were clearly defined along the lines of sex distribution. Measurements on the radiographs showed a significant difference between sexes in the metaphyseal diameter and thus in the percentage of the femoral canal that was filled by the prosthesis and cement. We concluded that prosthetic design must incorporate cortical cement support to reduce stress at the cement-bone interface, especially in a medullary canal with a larger diameter.     

Flexion Contracture Persists If the Contracture is More Than 15° at 3 Months After Total Knee Arthroplasty

After total knee arthroplasty, it is common for flexion contracture to exist during the early stages of postoperative course. We retrospectively investigated whether the early postoperative contracture would finally disappear, in 104 osteoarthritic knees after surgery with posterior-stabilized prostheses. The knees were divided into 5 groups based on their contracture 3 months after surgery (group I: no contracture, group II: 5°, group III: 10°, group IV: 15°, group V: ≥20°). The proportion of patients with residual contracture (≥5°) 2 years after surgery was 1/34 in group I, 4/30 in group II, 6/23 in group III, 6/6 in group IV, and 11/11 in group V. The results show that flexion contracture eventually existed if the contracture was more than 15° 3 months after surgery.     

旋转平台与固定平台假体全膝人工关节置换术的早期疗效比较

目的比较全膝人工关节置换术应用强生旋转平台与固定平台两种假体术后早期临床疗效。 方法回顾性收集2017年1月至2018年01月济宁医学院附属医院收治的79例86侧膝关节骨性关节炎患者进行回顾性研究,其中43例46膝应用强生旋转平台,其中男性18例（18膝,39.13%）,女性25例（28膝,60.87%）;左侧25膝（54.35%）,右膝21膝（45.65%）,年龄为55~77岁,平均（68±8）岁。36例（40膝）应用强生固定平台,其中男性16例（17膝,42.50%）,女性20例（23膝,57.50%）;左侧22膝（55.00%）,右膝18膝（45.00%）。年龄为54~80岁,平均（67±8）岁。所有患者均由同一位医师行固定平台假体或旋转平台假体初次TKA术。分别于手术前后评估膝关节HSS评分、膝关节活动度。 结果固定平台组或旋转平台组患者的术前活动度与末次随访活动度相比,差异均具有统计学意义（t=26.801,t=21.470,P<0.05）;固定平台组或旋转平台组患者的术前HSS评分与末次随访HSS评分相比,差异均具有统计学意义（t=35.180,t=35.053,P<0.05）。固定平台组与旋转平台组患者比较,术前及末次随访活动度差异均无统计学意义（均P>0.05）,固定平台组与旋转平台组患者比较,术前及末次随访HSS评分差异均无统计学意义（均P>0.05）。 结论旋转平台假体与固定平台假体TKA术后早期临床总体疗效相似。两种假体均能明显改善膝关节活动度及膝关节功能。无论使用哪种假体,短期随访时间内都不会影响到效果。