Scharf H-P, Schulze A
Orthopädisch-Unfallchirurgisches Zentrum, Universitätmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany.
Chirurg. 2010 Apr;81(4):293-8. doi: 10.1007/s00104-009-1843-4.
The number of knee arthroplasties in Germany increases about 6.8% annually. Parallel to the increasing number of primary total knee arthroplasties (TKA) the frequency of TKA revision surgery also goes up and is a growing challenge for orthopedic surgeons. The main reason for revision arthroplasty is aseptic or septic mechanical loosening of the implant. Other reasons are persisting pain, instability or limited range of motion. The aim of preoperative evaluation by examination, x-ray control and serum tests is to understand the mechanism of implant failure. Besides the stable mechanical fixation of the new implant, reconstruction of limb alignment, joint line and balanced extension and flexion gaps must be achieved. Bone defects also need to be reconstructed. Modular revision implants and bone grafts support the surgeon in restoring a pain-free knee function.
德国膝关节置换手术的数量每年约增长6.8%。随着初次全膝关节置换术（TKA）数量的增加，TKA翻修手术的频率也在上升，这对骨科医生来说是一个日益严峻的挑战。翻修置换术的主要原因是植入物的无菌性或感染性机械松动。其他原因包括持续疼痛、不稳定或活动范围受限。通过检查、X线控制和血清检测进行术前评估的目的是了解植入物失败的机制。除了新植入物的稳定机械固定外，还必须实现肢体对线、关节线以及屈伸间隙的平衡重建。骨缺损也需要进行重建。模块化翻修植入物和骨移植有助于外科医生恢复无痛的膝关节功能。
