Seldes R M, Tan V, Duffy G, Rand J A, Lotke P A
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
J Arthroplasty. 1999 Aug;14(5):533-7. doi: 10.1016/s0883-5403(99)90073-6.
There have been only a few reports that evaluate the outcome of total knee arthroplasty in patients with steroid-induced osteonecrosis of the knee. We retrospectively reviewed 31 total knee arthroplasties in 24 patients with confirmed steroid-induced osteonecrosis of the knee. The average follow-up was 64 months. Of surviving knees, 92% had significant improvement in knee scores. Five knees (16%) required a revision procedure. Reasons for revision were aseptic loosening in 3 knees and sepsis in 2 knees. Complications not requiring revision occurred in 6 of 31 knees (19%). Survivorship of total knee arthroplasty to revision in patients with steroid-induced avascular necrosis of the knee was 84% at 5 years. Although there was a slightly higher complication rate, this may, in part, be due to the severity of the patients' underlying disease processes. Total knee arthroplasty can be a successful procedure for chronically ill patients with steroid-induced osteonecrosis.
仅有少数报告评估了类固醇诱导的膝关节骨坏死患者全膝关节置换术的结果。我们回顾性分析了24例确诊为类固醇诱导的膝关节骨坏死患者的31例全膝关节置换术。平均随访时间为64个月。在存活的膝关节中，92%的膝关节评分有显著改善。5个膝关节（16%）需要翻修手术。翻修原因是3个膝关节无菌性松动，2个膝关节感染。31个膝关节中有6个（19%）发生了无需翻修的并发症。类固醇诱导的膝关节缺血性坏死患者全膝关节置换术至翻修的5年生存率为84%。尽管并发症发生率略高，但这可能部分归因于患者潜在疾病过程的严重程度。全膝关节置换术对于患有类固醇诱导的骨坏死的慢性病患者可能是一种成功的手术。
