创伤后踝关节骨关节炎的踝关节植入关节成形术替代方案。

Alternatives to ankle implant arthroplasty for posttraumatic ankle arthrosis.

作者信息

Zgonis Thomas, Roukis Thomas S, Polyzois Vasilios

机构信息

Department of Orthopaedics/Podiatry Division, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7776, San Antonio, TX 78229, USA.

出版信息

Clin Podiatr Med Surg. 2006 Oct;23(4):745-58, vii. doi: 10.1016/j.cpm.2006.07.001.

DOI:10.1016/j.cpm.2006.07.001

PMID:17067892

Abstract

Various surgical options beyond implant arthroplasty are available to treat posttraumatic ankle arthrosis. Conservative options are usually employed in combination and include the use of nonsteroidal anti-inflammatories, bracing, and orthoses, as well as injections of intra-articular corticosteroid and hyaluronic acid. If these conservative treatments fail, surgical intervention can be entertained. Alternatives to total ankle implant arthroplasty include (1) arthroscopic debridement, (2) arthrodiastasis, (3) peri-articular resurfacing using allograft or cartilage transplantation, and (4) peri-articular osteotomies to correct angular, rotational, or translational malalignment. However, ankle arthrodesis is the standard technique for end-stage ankle arthrosis. This article reviews the literature and presents an in-depth surgical technique for each procedure. The article also describes how to prevent and address the most common complications.

摘要

除了植入式关节成形术外，还有多种手术选择可用于治疗创伤后踝关节骨关节炎。保守治疗通常联合使用，包括使用非甾体抗炎药、支具和矫形器，以及关节内注射皮质类固醇和透明质酸。如果这些保守治疗失败，可以考虑手术干预。全踝关节植入式关节成形术的替代方法包括：（1）关节镜清创术；（2）关节扩张术；（3）使用同种异体移植物或软骨移植进行关节周围表面置换；（4）关节周围截骨术以纠正角度、旋转或平移畸形。然而，踝关节融合术是终末期踝关节骨关节炎的标准技术。本文回顾了相关文献，并介绍了每种手术的详细技术。本文还描述了如何预防和处理最常见的并发症。