류마토이드 및 골관절염에 대한 인공 슬관절의 방사선적 결과 분석

Although long term studies of the total knee arthroplasty have confirmed reliable relief of pain and maintenance of function, the late fioosening of the component being the most serious complication. So we analyzed the radiological results of the cementless total knee arthroplasty performed in osteoathritis and rheumatoicl arthritis. The cementless totaI knee arthroplasty was performed in 48 osteoarthritis knees and 28 rheumatoid arthritis knees from Fehurary 1987 to December 1992. The clinical and radiological analysis were performed between two groups using the American Knee Society roentgenographic evaluation and Hospital for Special Surgery knee score system. The foliow up period was ranged from 36 months to 96 months ( average 50 months ). The clinical results including knee scores and range of motion were similar in hoth groups. The improvement of range of motion and flexion contracture after total knee arthroplasty was remarkable in rheumatoid arthritis group. There was no signifcant differences in radiological results between the osteoarthritis,md the rheumatoid arthritis. In rheumatoid arthritis(81%) the radiolucent ]ines were more frequently ohserved than in osteoarthritis(73%), but the appearance of the lines was earlier in osteoarthritis(6 month) than in rheumatoid arthritis(8 tnonth), The radiolucent lines showed higher frequency in zone 4 on the femoral side in both y oups. On the tibial side the osteoarthritis showed higher frequency in zone 4 and the rheumatoid arthritis in zone 1. "I'he radiolucent1inc.s were found more frequently on the tibial side(76%) than the femoral side(51%). In conclusion, there was no significant difference in clinical and radiological results between the osteoarthritis and the rheumatoid arthritis group after coment1ess fixation method. Even in the patient with the poor bone stock like rheumatoid arl.hritis, there seems to he no relations of the bone ingrowth hetween the component. And incomplete radiolucent lines may he of minor c]inical importance, but progressive and continuous lines suggest potential loosening shouM be considered carefully.