Fitzgerald Steven J, Trousdale Robert T
Department of Orthopedic Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
Orthopedics. 2011 Sep 9;34(9):e513-5. doi: 10.3928/01477447-20110714-45.
The outcome of total knee arthroplasty (TKA) is influenced by multiple interconnected factors, including patient selection, implant design, and surgical technique. Total knee arthroplasty has been shown to be highly successful, with patient satisfaction rates reported from 85% to 95% with low rates of failure, but if failure occurs, its impact is significant. In 2003, 402,000 primary TKAs and 32,000 revision TKAs were performed in the United States, and the number of TKAs is expected to double by 2015. Recent data on modern implant designs and techniques have demonstrated a surprising number of early failures, although the true number of early failures is unknown. Patient medical comorbidities should be optimized preoperatively, while psychosocial issues and workers compensation are more nebulous yet contribute greatly to patient perceived outcomes. Understanding current failure mechanisms of primary TKA and how to prevent complications will be critical to help manage a potentially overwhelming TKA revision burden. This article discusses failure rates as well as factors from the patient, surgeon, and device, that contribute to TKA failure.
全膝关节置换术（TKA）的结果受到多种相互关联的因素影响，包括患者选择、植入物设计和手术技术。全膝关节置换术已被证明非常成功，患者满意度报告为85%至95%，失败率较低，但如果发生失败，其影响是重大的。2003年，美国进行了402,000例初次全膝关节置换术和32,000例翻修全膝关节置换术，预计到2015年全膝关节置换术的数量将翻倍。关于现代植入物设计和技术的最新数据显示，早期失败的数量惊人，尽管早期失败的真实数量尚不清楚。患者的内科合并症应在术前得到优化，而社会心理问题和工伤赔偿则较为模糊，但对患者的感知结果有很大影响。了解初次全膝关节置换术当前的失败机制以及如何预防并发症对于帮助应对潜在的巨大全膝关节置换术翻修负担至关重要。本文讨论了失败率以及来自患者、外科医生和器械方面导致全膝关节置换术失败的因素。
