MacDonald James H, Agarwal Sanjeev, Lorei Matthew P, Johanson Norman A, Freiberg Andrew A
Orthopaedic and Sports Medicine Center, 108 Forbes Street, Annapolis, MD 21401, USA.
J Am Acad Orthop Surg. 2006 Mar;14(3):154-63. doi: 10.5435/00124635-200603000-00006.
Arthrodesis is one of the last options available to obtain a stable, painless knee in a patient with a damaged knee joint that is not amenable to reconstructive measures. Common indications for knee arthrodesis include failed total knee arthroplasty, periarticular tumor, posttraumatic arthritis, and chronic sepsis. The primary contraindications to knee fusion are bilateral involvement or an ipsilateral hip arthrodesis. A variety of techniques has been described, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Allograft or autograft may be necessary to restore lost bone stock or to augment fusion. For the carefully selected patient with realistic expectations, knee arthrodesis may relieve pain and obviate the need for additional surgery or extensive postoperative rehabilitation.
关节融合术是为膝关节受损且无法采用重建措施的患者获得稳定、无痛膝关节的最后选择之一。膝关节融合术的常见适应证包括全膝关节置换术失败、关节周围肿瘤、创伤后关节炎和慢性脓毒症。膝关节融合术的主要禁忌证是双侧受累或同侧髋关节融合术。已经描述了多种技术，包括外固定、用加压钢板内固定、通过膝关节用模块化钉进行髓内固定以及经梨状窝顺行穿钉。可能需要同种异体移植物或自体移植物来恢复丢失的骨量或增强融合。对于精心挑选且期望现实的患者，膝关节融合术可以缓解疼痛，避免进一步手术或广泛的术后康复。
