Orthopaedic and Arthritis Surgery Center, Surgical Center for Osteoarthritis treatment, Pr Argenson's Department, St Marguerite Hospital, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
Orthop Traumatol Surg Res. 2011 Oct;97(6 Suppl):S87-94. doi: 10.1016/j.otsr.2011.06.008. Epub 2011 Jul 28.
Over the past few years the use of arthroplasty was broadened to treating complex epiphyseal fractures at the shoulder and elbow joints. Similar trends to treat this type of fractures at the knee are less documented. Based on a multicenter retrospective series study, the aims of this work is to evaluate the short term clinical results of total knee prostheses in the management of comminuted epiphyseal fractures around the knee, to identify the technical issues and fine tune the indications.
Following the initiative of the French Hip and Knee Society (SFHG) and the Traumatology Study Group (GETRAUM), 26 charts from eight different centers in France were included in this multicenter retrospective series. Inclusion criteria were: primary total knee arthroplasty (TKA) in the management of complex articular fractures involving the proximal end of the tibia or distal end of the femur. Surgical features were identified and complications were analyzed. The assessment protocol at last follow-up was standardized and included patient demographic data, analysis of the Parker and IKS scores.
During the immediate postoperative period, six patients (23%) reported a general complication and four patients (15%) a local arthroplasty-related complication. At last follow-up (mean 16.2 months), the overall final Parker score was 6.3 (a mean decrease of 1.7) and the mean IKS knee score was 82 points for a mean function score of 54 points.
Primary TKA is a suitable management option for complex fractures in autonomous elderly patients suffering from knee osteoarthritis. The key technical details of this procedure should be respected and meticulously planned to achieve optimal results and limit the risk of complications. This risk in these acute complex fractures remains higher than after conventional TKA but comparable to that observed after TKA for post-traumatic arthritis.
IV; retrospective cohort study.
在过去的几年中，关节置换术的应用范围已经扩大到治疗肩部和肘部复杂骺板骨折。在膝关节治疗这种类型骨折的类似趋势记录较少。基于多中心回顾性系列研究，本研究旨在评估全膝关节假体治疗膝关节周围粉碎性骺板骨折的短期临床结果，确定技术问题并调整适应证。
在法国髋关节和膝关节学会（SFHG）和创伤学研究组（GETRAUM）的倡议下，从法国的 8 个不同中心纳入了 26 份病历进行多中心回顾性系列研究。纳入标准为：原发性全膝关节置换术（TKA）治疗涉及胫骨近端或股骨远端的复杂关节内骨折。确定了手术特点并分析了并发症。最后随访的评估方案标准化，包括患者的人口统计学数据、帕克（Parker）和 IKS 评分分析。
在术后即刻，6 名患者（23%）报告了一般并发症，4 名患者（15%）报告了局部关节置换相关并发症。最后随访（平均 16.2 个月），总最终帕克评分（Parker score）为 6.3（平均降低 1.7），平均 IKS 膝关节评分为 82 分，平均功能评分为 54 分。
原发性 TKA 是自主老年膝关节骨关节炎患者治疗复杂骨折的合适选择。该手术的关键技术细节应得到尊重并精心规划，以达到最佳效果并降低并发症风险。在这些急性复杂骨折中，这种风险高于常规 TKA，但与创伤后关节炎后 TKA 观察到的风险相当。
IV；回顾性队列研究。
