Ries M D, Badalamente M
Department of Orthopaedic Surgery, UCSF Medical Center, San Francisco, CA 94143-0728, USA.
Clin Orthop Relat Res. 2000 Nov(380):177-83. doi: 10.1097/00003086-200011000-00024.
Six total knee arthroplasties in five patients were revised because of persistent limited motion after the primary arthroplasty. All of the revised implants were of an appropriate size and not malpositioned. No cause of stiffness was identified other than soft tissue contracture. Four of the components were posterior cruciate retaining and two were posterior cruciate substituting. Heterotopic bone formation was observed in two knees before the revision surgery and five knees after the revision surgery. Arc of motion was increased from 36 degrees (range, 20 degrees-70 degrees) before revision surgery to 86 degrees (range, 70 degrees-110 degrees) after revision surgery. What triggers the proliferation of extensive scar tissue formation in patients with arthrofibrosis is not clear. Some patients may be predisposed to this condition or may have it develop as a response to the surgical trauma and postoperative rehabilitation. However, when arthrofibrosis does develop after total knee arthroplasty, some improvement in motion and pain can be achieved with revision surgery.
五名患者的六次全膝关节置换术因初次置换术后持续存在活动受限而进行翻修。所有翻修植入物尺寸合适且位置无异常。除软组织挛缩外，未发现导致僵硬的其他原因。四个组件为后交叉韧带保留型，两个为后交叉韧带替代型。翻修手术前在两个膝关节中观察到异位骨形成，翻修手术后在五个膝关节中观察到异位骨形成。活动弧从翻修手术前的36度（范围为20度至70度）增加到翻修手术后的86度（范围为70度至110度）。关节纤维化患者中引发广泛瘢痕组织形成增殖的原因尚不清楚。一些患者可能易患此病，或者可能因手术创伤和术后康复而引发。然而，当全膝关节置换术后确实发生关节纤维化时，翻修手术可在一定程度上改善活动度和疼痛。
