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[膝关节镜检查的并发症]

[Complications of knee arthroscopy].

作者信息

Mayr H O, Stoehr A

机构信息

OCM-Klinik, Steinerstr. 6, 81369, München, Deutschland.

出版信息

Orthopade. 2016 Jan;45(1):4-12. doi: 10.1007/s00132-015-3182-0.

Abstract

BACKGROUND

Today, knee arthroscopy is one of the standard interventions performed by an orthopaedist and usually has a low potential for complications.

PURPOSE

The surgeon should still be aware of possible problems, and be able to control and explain them to the patient in detail before surgery.

MATERIALS AND METHODS

The possible relevant peri-, intra- and postoperative complications of knee arthroscopy are discussed.

RESULTS

Evaluation of the patient's medical history and comorbidities is crucial to successful treatment, in addition to a correct diagnosis and indications with the assistance of appropriate imaging procedures. Nervous and vascular injuries, malplacement of arthroscopy portals, thrombosis, air embolism, material breakage and a possible compartment syndrome constitute the peri-and intraoperative complications. Postoperatively, the most frequent negative events are haemarthrosis, thrombosis, embolism and infection, and the appearance of synovial fistulas. In the case of a joint infection, consistent and immediate diagnosis and therapy are vital for joint preservation. Late complications after arthroscopic interventions include Ahlback's disease, arthrofibrosis and complex regional pain syndrome (CRPS).

DISCUSSION

Nowadays, the systematic education of arthroscopic surgeons using simulators, models, and cadavers, in addition to shadowing experienced arthroscopists, is required to offer patients the best therapeutic options.

摘要

背景

如今,膝关节镜检查是骨科医生进行的标准干预措施之一,通常并发症发生的可能性较低。

目的

外科医生仍应了解可能出现的问题,并能够在手术前向患者详细说明并加以控制。

材料与方法

讨论膝关节镜检查可能相关的围手术期、术中及术后并发症。

结果

除了在适当的影像学检查辅助下进行正确诊断和明确适应症外,评估患者的病史和合并症对成功治疗至关重要。神经和血管损伤、关节镜入口位置不当、血栓形成、空气栓塞、材料破损以及可能出现的骨筋膜室综合征构成围手术期和术中并发症。术后,最常见的不良事件是关节积血、血栓形成、栓塞和感染,以及滑膜瘘的出现。对于关节感染,持续且及时的诊断和治疗对于保留关节至关重要。关节镜干预后的晚期并发症包括阿尔贝克病、关节纤维性强直和复杂性区域疼痛综合征(CRPS)。

讨论

如今,除了跟随经验丰富的关节镜医生学习外,还需要使用模拟器、模型和尸体对关节镜外科医生进行系统培训,以便为患者提供最佳治疗选择。

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