Kao Feng-Chen, Hsu Kuo-Yao, Tu Yuan-Kun, Chou Ming-Chih
Institute of Medicine of Chung Shan Medical University, Taichung, Taiwan, Republic of China.
Orthopedics. 2009 Nov;32(11):810. doi: 10.3928/01477447-20090922-05.
Most total knee arthroplasties (TKAs) are performed for minimal knee joint deformities with standard techniques and instrumentation. However, patients with extra-articular deformities, severe varus and valgus deformities, and posttraumatic arthrosis pose unique challenges to surgeons. Each deformity requires different modifications of surgical technique or prosthesis used to successfully perform TKA and optimize postoperative results. The surrounding tissues connect the femur and the tibia at the anterior, posterior, medial, and lateral walls of the knee joint. The medial soft tissues should be released for varus deformities and lateral soft tissues should be released for valgus deformities. The posterior soft tissue may be released for flexed deformities. The anterior quadriceps and patellar tendon may be adjusted while approaching the knee joint for posttraumatic arthrosis. A more constrained knee prosthesis may be needed for more severe deformities.
大多数全膝关节置换术（TKA）采用标准技术和器械，针对膝关节轻度畸形进行。然而，患有关节外畸形、严重内翻和外翻畸形以及创伤后关节炎的患者给外科医生带来了独特的挑战。每种畸形都需要对手术技术或所使用的假体进行不同的调整，以成功实施TKA并优化术后效果。膝关节的前、后、内侧和外侧壁周围的组织连接股骨和胫骨。对于内翻畸形应松解内侧软组织，对于外翻畸形应松解外侧软组织。对于屈曲畸形可松解后侧软组织。对于创伤后关节炎，在接近膝关节时可调整股四头肌和髌腱。对于更严重的畸形可能需要更具限制性的膝关节假体。
