Patel Jay, Ries Michael D, Bozic Kevin J
Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA.
Instr Course Lect. 2008;57:283-94.
Extensor mechanism complications after total knee arthroplasty are relatively uncommon but potentially devastating. The etiology of these complications, which includes patellofemoral instability, periprosthetic patellar fracture, and disruptions of the quadriceps tendon and patellar ligament, has become better defined in recent years, with a subsequent decrease in the incidence, primarily resulting from changes in surgical technique and component design. In addition to addressing the patient's specific failure mechanism, the treatment of extensor mechanism complications after total knee arthroplasty may include nonsurgical management, primary repair, or reconstruction with autogenous, allogeneic, or synthetic tissue. Prevention of these complications, the foremost goal, is achieved through identification of patient and procedure risk factors, meticulous surgical technique, including vigilance during exposure and retractor placement, and a high index of suspicion both during and after the procedure.
全膝关节置换术后伸肌机制并发症相对少见，但可能具有毁灭性。这些并发症的病因，包括髌股关节不稳定、假体周围髌骨骨折以及股四头肌腱和髌韧带断裂，近年来已得到更明确的界定，其发生率随后有所下降，这主要归因于手术技术和假体设计的改变。除了针对患者特定的失败机制外，全膝关节置换术后伸肌机制并发症的治疗可能包括非手术治疗、一期修复或使用自体、异体或合成组织进行重建。预防这些并发症是首要目标，可通过识别患者和手术风险因素、采用细致的手术技术（包括在暴露和放置牵开器时保持警惕）以及在手术期间和术后保持高度怀疑来实现。
