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单髁膝关节置换术后并发症的分析与治疗

Analysis and Treatment of Complications after Unicompartmental Knee Arthroplasty.

作者信息

Kim Kyung Tae, Lee Song, Lee Jae Il, Kim Jin Woo

机构信息

Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.

出版信息

Knee Surg Relat Res. 2016 Mar;28(1):46-54. doi: 10.5792/ksrr.2016.28.1.46. Epub 2016 Feb 29.

Abstract

PURPOSE

To analyze the causes and types of complications after unicompartmental knee arthroplasty (UKA) and determine proper prevention and treatment methods.

MATERIALS AND METHODS

A total of 1,576 UKAs were performed for osteoarthritis of the knee from January 2002 to December 2014 at one institution. We analyzed complications after UKA retrospectively and investigated proper methods of treatment.

RESULTS

A total of 89 complications (5.6%) occurred after UKA. Regarding the type of complications after UKA, there were 42 cases of dislocation of the mobile bearing, 23 cases of loosening of the prosthesis, 6 cases of periprosthetic fracture, 3 cases of polyethylene wear, 3 cases of progression of arthritis in the contralateral compartment, 2 cases of medial collateral ligament injury, 2 cases of impingement, 5 cases of infection, 1 case of arthrofibrosis, and 2 cases of failure due to unexplained pain. The most common complication after UKA was mobile bearing dislocation in the mobile-bearing knees and loosening of the prosthesis in the fixed-bearing knees, but polyethylene wear and progression of arthritis were relatively rare. The complications were treated with conversion to total knee arthroplasty in 58 cases and simple bearing change in 21 cases.

CONCLUSIONS

The most common complication after UKA was dislocation of the mobile bearing. When a complication occurs after UKA, appropriate treatment should be performed after accurate analysis of the cause of complication.

摘要

目的

分析单髁膝关节置换术(UKA)后并发症的原因及类型,并确定合适的预防和治疗方法。

材料与方法

2002年1月至2014年12月期间,在一家机构对1576例因膝关节骨关节炎行单髁膝关节置换术的患者进行了回顾性分析,分析UKA术后并发症情况,并探讨合适的治疗方法。

结果

UKA术后共发生89例并发症(5.6%)。UKA术后并发症类型包括:活动平台脱位42例、假体松动23例、假体周围骨折6例、聚乙烯磨损3例、对侧间室关节炎进展3例、内侧副韧带损伤2例、撞击2例、感染5例、关节纤维化1例、不明原因疼痛导致手术失败2例。UKA术后最常见的并发症是活动平台膝关节的活动平台脱位和固定平台膝关节的假体松动,而聚乙烯磨损和关节炎进展相对少见。58例并发症患者接受了全膝关节置换术,21例患者进行了单纯的衬垫更换。

结论

UKA术后最常见的并发症是活动平台脱位。UKA术后发生并发症时,应在准确分析并发症原因后进行适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/620e/4779805/558ae29e6db1/ksrr-28-46-g001.jpg

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