퇴행성 골관절염 환자에 시행한 무시멘트 Ortholoc 형 슬관절 전치환술 = Cementless Ortholoc Total Knee Arthroplasty in Osteoarthritis

다국어 초록 (Multilingual Abstract)

Advantages of cementless artkropIasty are preservation of bone stock. The most encouraging aspect of this series of total knee arthroplasties is the ease of revisability in the components. Ortholoc Knee has the accuracy and reproducibility of hone cutting with the effective intramedullary alignment system and the rigid fixation of the tibial component by using screw and pegs. The patella component is inset-patella type. From Octoher 1990 to May 1993, the authors analyzed 50 patients, 82 cementless Ortholoc II and Ortholoc Modular tota] knee arthroplasty in osteoarthritis with an average 3 years 3 months (range 2 ycars to 4 years 6 months) follow up period. There were 35 cases in left side of knee, 47 cases in right side, 43 patients in female and 7 patients in male. The average age was 61.5 years (range 28 to 77 years). At the clinical analysis, preopera(.ive average HSS knee rating score was 56.5 point (31 to 82 points). At the last follow up, HSS Knee rating score was 91.2 point (85 to 98 points). Preoperative average ROM was 108.7 degrees (70 to 120 degrees). At the 1ast follow up ROM was 118.5 degrees (90 to 135 degrees). Preoperative flexion contracture was average I0.7 degrees (0 to 40 degrees). At the last follow up, flexion contracture was average 0,6 degree (0 to 10 degrees). For the radiographical analysis, American Knee Society Roentgenographic Evaluation and Scoring System was used. The ccmponent position was as follows; average value of' a angle was 93.8 degrees(89-100), p angle was 90.4 degrees(86-98) in anteroposterior view and g angle was S.2 degrees(0-18), 8 angle was 90A degrees(83-98) in lateral view. In the plain AP view, preoperative average tibiofemoral shaft;mgle was varus 8.5 degrees (range varus 3 to 25 degrees). Postoperative average tibiofemoral shaft angle was corrected as valgus 6.5 degrees (range 4 to 10 degrees). Regarding the position of central stern to tibial shaft axis, 38 cases were found to be located in lateral side, 30 cases in medial side, and 14 cases in neutral side. Tiltin angle of tibial tray to the perpendicular articular line of tibial shaft axis was average 1.7 degrees (rarvc I to 4 clerees) in cases with valgus alignment of tibial components and -2A degrees (range - I to -5 degrees) in cases with varus alignment, The distance between axial lines of tibial component and tihial shaft was average 4.7mm (range l to 6mm) in valgus alignment, and 5.3mm (range I to 7mm) in varus alignment. There was no loosening and wear The clinical and radiological findings revealed no distinc1 differcnces between these two implants. In summary, total knee replacement without using bone cement is a rclinhle and effective methocf of treating degenerative arthritic knee. The accuracy of hone cutting and the femoral and tihial entry p(oints of intramedullary rod are very important for the correct insertion andd alignment of prosthetic component..