Lonner Jess H, Lotke Paul A, Kim Jane, Nelson Charles
Orthopaedics, Pennsylvania Hospital, Philadelphia, 19107, USA.
Clin Orthop Relat Res. 2002 Nov(404):145-51. doi: 10.1097/00003086-200211000-00026.
The current authors review the results of 17 revision total knee arthroplasties in 14 patients in whom large uncontained defects were treated with impaction allografting and molded wire mesh for containment. Knee Society clinical scores increased from an average of 47 points to 95 points and function scores increased from 48 points to 73 points at the most recent followup. No patients required revision surgery, although, nonprogressive tibial radiolucency has been observed in three patients. One patient required open reduction and internal fixation of a periprosthetic supracondylar femur fracture. One patient with an acute postoperative infection with Staphylococcus epidermidis was treated successfully with irrigation and debridement with retention of the implant. Impaction grafting with wire mesh containment for large uncontained defects in revision total knee arthroplasty is an effective method of treating massive uncontained bone loss in revision total knee arthroplasty.
本文作者回顾了14例患者的17次全膝关节置换翻修手术结果，这些患者存在大面积非包容性缺损，采用嵌压异体骨移植和塑形金属丝网进行包容治疗。在最近一次随访时，膝关节协会临床评分从平均47分提高到95分，功能评分从48分提高到73分。尽管有3例患者出现非进行性胫骨透亮线，但无患者需要再次手术。1例患者需要对假体周围股骨髁上骨折进行切开复位内固定。1例术后急性表皮葡萄球菌感染患者通过冲洗清创并保留假体成功治愈。在全膝关节置换翻修术中，采用金属丝网包容的嵌压植骨术治疗大面积非包容性缺损是治疗全膝关节置换翻修术中大量非包容性骨丢失的有效方法。
