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单髁膝关节置换失败后的翻修手术:技术要点与临床结果

Revision surgery for failed unicompartmental knee replacement: technical aspects and clinical outcome.

作者信息

Robb Curtis A, Matharu Gulraj S, Baloch Khalid, Pynsent Paul B

机构信息

Royal Orthopaedic Hospital, Birmingham, UK.

出版信息

Acta Orthop Belg. 2013 Jun;79(3):312-7.

Abstract

The aims of this study were to determine the complexity of surgery required to revise failed unicompartmental knee replacements and to evaluate the outcome following revision. Between 2000 and 2009, 494 cemented Oxford phase 3 medial unicompartmental knee replacements were implanted, with 24 (4.9%) requiring revision (mean age: 63.5 years; 58% male). Mean time to revision was 3.0 years. All cases were revised to a cemented total knee replacement, with primary components used in 67% and revision components in 33%. At a mean follow-up of 3.2 years the median Oxford knee score was 333% with one knee requiring re-revision (5-year survival 933%). Most failed unicompartmental knee replacements could be revised without the need for stemmed implants, augmentation, or bone allograft. When bone loss occured it was commonly on the tibial side. Good functional outcome for the revised unicompartmental knee replacement was achieved and was comparable to primary knee replacement.

摘要

本研究的目的是确定翻修失败的单髁膝关节置换术所需手术的复杂性,并评估翻修后的结果。2000年至2009年间,共植入了494例骨水泥型牛津三期内侧单髁膝关节置换术,其中24例(4.9%)需要翻修(平均年龄:63.5岁;男性占58%)。翻修的平均时间为3.0年。所有病例均翻修为骨水泥型全膝关节置换术,67%使用初次置换组件,33%使用翻修组件。平均随访3.2年时,牛津膝关节评分中位数为333%,有一例膝关节需要再次翻修(5年生存率933%)。大多数失败的单髁膝关节置换术可以在无需带柄植入物、增强材料或骨移植的情况下进行翻修。当出现骨丢失时,通常发生在胫骨侧。翻修后的单髁膝关节置换术取得了良好的功能结果,与初次膝关节置换术相当。

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