Reichel H, Hube R, Birke A, Hein W
Universitätsklinik und Poliklinik für Orthopädie und Physikalische Medizin der Martin-Luther-Universität Halle-Wittenberg, Germany.
Zentralbl Chir. 2002 Oct;127(10):880-5. doi: 10.1055/s-2002-35134.
The goal of bone reconstruction in revision total knee arthroplasty is to provide a stable support for the implant and to re-establish the correct joint line. Therefore, a useful, therapy-based classification of the defects is necessary. According to Stockley et al. (1992), the defects are classified into contained and uncontained defects. Uncontained defects can be reconstructed using structural allografts or metal wedges. In contained defects, cancellous allograft can be used. For aseptic loosening of total knee arthroplasty, the defect classification according to Engh and Parks (1994) can be helpful because of its recommendations for reconstruction. In case of the more common first or second graded defects, reconstruction is performed using modular revision components or allografts. For the rare third graded defects, bulk allografts or modular tumour endoprostheses are recommended. On the basis of more than 150 revision total knee arthroplasties performed in our hospital the classification of bone defects and their clinical consequences are presented in this review.
翻修全膝关节置换术中骨重建的目标是为植入物提供稳定支撑并重新建立正确的关节线。因此，基于治疗方法对骨缺损进行分类很有必要。根据斯托克利等人（1992年）的研究，骨缺损分为包容性缺损和非包容性缺损。非包容性缺损可使用结构性同种异体骨或金属楔块进行重建。对于包容性缺损，可使用松质骨同种异体骨。对于全膝关节置换术的无菌性松动，恩格和帕克斯（1994年）的骨缺损分类有助于指导重建。对于较常见的一级或二级骨缺损，可使用模块化翻修组件或同种异体骨进行重建。对于罕见的三级骨缺损，建议使用大块同种异体骨或模块化肿瘤假体。基于我院进行的150余例翻修全膝关节置换术，本文对骨缺损的分类及其临床后果进行了阐述。
