| Objective: To clarify the early and mid-term clinical result of the TKA with Gemini MKII knee prostheis（Link,Germany）.Methods:From January2004to June2009,143patients(158knees) including57males and86females at mean63.1±10.7years were treated with total knee arthroplasty by usingGemini MKⅡ system. Body mass index (BMI) averaged26.8±2.4.128Unilateral cases,15bilateral cases. Preoperative diagnosis:109(121knees) Degenerative osteoarthritis,21(24knees) Rheumatoid arthritis,11(11knees) Post-traumatic arthritis,1(1knee)Charcot’s disease,1(1knee) Hemophilic arthritis.Prosthesis were fixed with bone cement.No one with patellar replacement. In male cases, the mean age is65.2±8.5years with theBMI25.4±1.3.48Unilateral cases,9bilateral cases.Preoperative diagnosis:44(51knees)Degenerative osteoarthritis,5(7knees) Rheumatoid arthritis,6(6knees) Post-traumaticarthritis,1(1knee) Charcot’s disease,1(1knee) Hemophilic arthritis. In female cases, themean age is61.5±13.5years with the BMI27.6±4.1.80Unilateral cases,6bilateral cases.Preoperative diagnosis:65(69knees) Degenerative osteoarthritis,16(18knees)Rheumatoid arthritis,5(5knees) Post-traumatic arthritis.Results: No one case of infection, femoral condyle fracture or nerve, vascular damage andother complications. Except unilateral TKA, the average operation time was60minutes(range:45-90minutes), and the average postoperative hemoglobin(Hb) decreased2.5±0.5g/L.108patients (84.4%) without blood transfusion, because of postoperative Hbremained in100g/L or more. The mean follow-up was4.6±1.8years, and76patients haveat least5years follow-up.1. Clinical Evaluation: The preoperative mean knee score, meanROM（range of motion）and mean function score respectively improved from46.7±7.2points to92.8±4.5points, from86.4±11.8°to114.7±8.1°and from47.8±8.8points to 90.4±6.5points at the most recent follow-up. The preoperative mean pain score and Fellarscore respectively improved from12.4±7.5points to45.3±4.6points and from18.2±4.5points to27.6±3.2points at the most recent follow-up.The postoperative knee score,function score, ROM, pain score and Fellar score were significant higher thanpreoperative(P<0.01). Comparing male with female, there were differences in thepreoperative and postoperative knee score(P=0.04,P=0.02), and the postoperative functionscore, ROM, pain score and Fellar score were no significant difference (P=0.94,P=0.96,P=0.44and P=0.83).2. Radiographic Evaluation: The angles were measured on theanteroposterior film and lateral radiography. Mean femoral angle96.3±1.1°, mean tibialangle89.7±1.5°, mean posterior slope angle of tibial plateau85.2±1.7°and mean femoralflexion angle1.4±0.5°. Comparing male with female, the femoral angle, tibial angle,posterior slope angle of tibial and femoral flexion angle were no significant difference(P=0.27,P=0.96,P=0.14and P=0.82). Coverage of the tibial plateau in the coronal andsagittal, respectively,96.4±3.1%and98.6±1.4%. NO significant difference between maleand female(P=0.23and P=0.43). No evidence of periprosthetic osteolysis,translucent linesand loosening on the postoperative X-ray film. No revision surgery for lining prolapse orspin out, osteolysis and prosthesis loosening.Conclusions: Performing TKA with Gemini MKⅡmobile rotating-platform prosthesis canalleviate pain and restore joint function effectively, simple operation, rapid postoperativerecovery, fewer complications. The early and midterm results of Gemini MKⅡmobilerotating-platform prosthesis was satisfactory both in male and female,but the long-termresults remains to be confirmed. |
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