Mihalko William M, Whiteside Leo A
Campbell Clinic Department of Orthopaedics & Biomedical Engineering, University of Tennessee, Memphis, Tennessee.
J Surg Orthop Adv. 2015 Summer;24(2):137-9.
Revision total knee arthroplasty (TKA) often requires long diaphyseal supporting stems. Pain at the end of the cemented revision stem has been reported, but no study has been published regarding the incidence in cementless revision TKA. This study reviewed 120 cementless revision TKAs with a diaphyseal slotted stem to compare the incidence of stem pain to that in a control cohort of 100 primary TKA patients with a metaphyseal stem. In the revision cohort, 20 out of 120 patients reported pain at the end of their stem on the tibia, but no patient reported thigh pain. In the primary TKA cohort, seven out of 100 patients reported pain below the tibial stem. No correlation between stem length or stem fit was found. This study found that more than 16% of patients may have pain at the end of their press-fit revision TKA stem, and this complication should be explained to patients before their revision TKA surgery.
翻修全膝关节置换术(TKA)通常需要长骨干支撑柄。已有报道称骨水泥固定翻修柄末端会出现疼痛,但关于非骨水泥固定翻修TKA中该发生率的研究尚未发表。本研究回顾了120例采用骨干开槽柄的非骨水泥固定翻修TKA,以比较柄部疼痛的发生率与100例采用干骺端柄的初次TKA患者对照组的发生率。在翻修队列中,120例患者中有20例报告胫骨侧柄末端疼痛,但无患者报告大腿疼痛。在初次TKA队列中,100例患者中有7例报告胫骨柄下方疼痛。未发现柄长度或柄适配情况之间存在相关性。本研究发现,超过16%的患者在压配式翻修TKA柄末端可能会出现疼痛,并且在患者进行翻修TKA手术前应向其解释这种并发症。