Kurup Harish V, Taylor Graeme R
Royal Glamorgan Hospital, Llantrisant, UK.
Int Orthop. 2008 Apr;32(2):243-6. doi: 10.1007/s00264-006-0300-y. Epub 2007 Jan 6.
Ankle replacements appear to offer a good alternative to fusion for most arthritic conditions. Use of mobile bearings has significantly improved results of ankle replacement. Ankle replacements still have a significant minor-complication rate which does not seem to affect the long-term outcome. Medial impingement as a complication has been reported with popular designs. We reviewed the senior author's first five years of Buechel-Pappas ankle replacements looking at AOFAS scores, VAS scores, patient satisfaction, learning curve of the surgeon and complications. Eight patients out of a total of 34 reported symptoms of medial impingement at follow-up. Four patients underwent revision surgery for this. Ankle replacements have a significant proportion of minor complications, one of which is medial impingement. Whether this is due to implant design, residual arthritis in medial recess or soft-tissue pathology is uncertain but revision surgery may be required.
对于大多数关节炎病症而言,踝关节置换术似乎是融合术的一个良好替代方案。活动轴承的使用显著改善了踝关节置换的效果。踝关节置换术仍有相当高的轻微并发症发生率,但这似乎并不影响长期疗效。一些流行的设计已报告了内侧撞击作为一种并发症。我们回顾了资深作者开展的前五年Buechel-Pappas踝关节置换术,观察美国足踝外科协会(AOFAS)评分、视觉模拟评分(VAS)、患者满意度、外科医生的学习曲线以及并发症情况。在总共34例患者中,有8例在随访时报告有内侧撞击症状。其中4例为此接受了翻修手术。踝关节置换术有相当比例的轻微并发症,其中之一就是内侧撞击。这是由于植入物设计、内侧隐窝残留关节炎还是软组织病变尚不确定,但可能需要进行翻修手术。