Manzotti A, Pullen C, Deromedis B, Catagni M A
Orthopaedic Department, Alessandro Manzoni Hospital, Lecco, Italy.
Clin Orthop Relat Res. 2001 Aug(389):143-9. doi: 10.1097/00003086-200108000-00020.
Numerous treatments have been proposed for infected total knee arthroplasty. In selected patients, a knee arthrodesis is a well-recognized salvage procedure. However, there are no reports in the literature discussing the treatment of infected total knee arthroplasty using the Ilizarov method. The authors reviewed their experience with this technique in infected total knee arthroplasty, presenting six patients (four women, two men) treated between 1992 and 1998. The average age was 56.6 years (range, 23-70 years) and the mean number of previous surgical procedures was seven (range, 4-10 procedures). From the time of frame removal, the patients were followed up for a mean of 34.2 months (range, 12.4-87.5 months). Full weight-bearing was allowed 1 week after surgery if half-pins were used and after a mean of 2.6 months if Kirschner wires were used. Of the five patients who have completed treatment, all have obtained a stable knee arthrodesis after a mean external fixation time of 6.8 months without additional surgical procedures or bracing. All of the patients were satisfied with the treatment. The authors recommend knee arthrodesis by the Ilizarov method for infected total knee arthroplasty, particularly in patients with extensive bone loss, significant limb shortening or axial deformity or both, active infection, or previous failed arthrodesis.
对于感染性全膝关节置换术，已经提出了多种治疗方法。在特定患者中，膝关节融合术是一种公认的挽救手术。然而，文献中没有关于使用伊里扎洛夫方法治疗感染性全膝关节置换术的报道。作者回顾了他们在感染性全膝关节置换术中应用该技术的经验，介绍了1992年至1998年间治疗的6例患者（4名女性，2名男性）。平均年龄为56.6岁（范围23 - 70岁），既往手术平均次数为7次（范围4 - 10次）。从拆除外固定架开始，患者平均随访34.2个月（范围12.4 - 87.5个月）。如果使用半针，术后1周允许完全负重；如果使用克氏针，则平均在2.6个月后允许完全负重。在完成治疗的5例患者中，平均外固定6.8个月后，均获得了稳定的膝关节融合，无需额外手术或支具。所有患者对治疗均满意。作者推荐使用伊里扎洛夫方法进行膝关节融合术治疗感染性全膝关节置换术，特别是对于有广泛骨质缺损、明显肢体短缩或伴有轴向畸形、存在活动性感染或既往膝关节融合术失败的患者。
