Lo Chun-Sheng, Wang Shyu-Jye, Wu Shing-Sheng
Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
J Arthroplasty. 2003 Sep;18(6):804-8. doi: 10.1016/s0883-5403(03)00331-0.
Two patients experiencing knee stiffness on extension subsequent to total knee arthroplasties (TKAs) are reported on in this paper. The use of an oversized femoral component is suggested as the main cause of the stiffness. Revision surgery using a smaller femoral component and resecting more bone from the posterior aspect of the distal femur than during initial TKA surgery was performed to expand the joint's flexion gap without affecting joint stability on extension. This procedure appeared to solve the pre-existing limitation in knee flexion experienced by both patients subsequent to the first TKA. This complication appears to be rarely referred to in the literature: we report on 2 such cases in this paper. The range of motion in the first case was from 5 degrees to 33 degrees before revision surgery. After revision, the range of motion improved to 0 degrees /90 degrees. The second case improved from 0 degrees /45 degrees to 0 degrees /110 degrees.
本文报道了2例全膝关节置换术（TKA）后出现膝关节伸直僵硬的患者。超大号股骨假体的使用被认为是导致僵硬的主要原因。进行了翻修手术，使用较小的股骨假体，并在股骨远端后侧比初次TKA手术时切除更多的骨组织，以扩大关节的屈曲间隙，同时不影响伸直时的关节稳定性。该手术似乎解决了2例患者初次TKA后膝关节屈曲存在的限制。这种并发症在文献中似乎很少被提及：本文报道了2例此类病例。第一例患者翻修手术前的活动范围为5度至33度。翻修后，活动范围改善至0度/90度。第二例患者从0度/45度改善至0度/110度。
