Lum Zachary C, Shieh Alvin K, Dorr Lawrence D
Department of Orthopaedic Surgery, Davis Medical Center, University of California, Sacramento, CA 95817, United States.
Department of Orthopaedic Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA 90033, United States.
World J Orthop. 2018 Apr 18;9(4):60-64. doi: 10.5312/wjo.v9.i4.60.
Historically, the most common mechanism of total knee arthroplasty (TKA) failures included aseptic loosening, instability and malalignment. As polyethylene production improved, modes of failure from polyethylene wear and subsequent osteolysis became less prevalent. Newer longitudinal studies report that infection has become the primary acute cause of failure with loosening and instability remaining as the overall greatest reasons for revision. Clinical database and worldwide national registries confirm these reports. With an increasing amount of TKA operations performed in the United States, and with focus on value-based healthcare, it is imperative to understand why total knees fail.
从历史上看，全膝关节置换术（TKA）失败的最常见机制包括无菌性松动、不稳定和排列不齐。随着聚乙烯生产工艺的改进，因聚乙烯磨损及随后的骨溶解导致的失败模式变得不那么普遍。更新的纵向研究报告称，感染已成为失败的主要急性原因，而松动和不稳定仍然是翻修的总体最大原因。临床数据库和全球各国的登记处证实了这些报告。在美国，随着全膝关节置换手术数量的增加，以及对基于价值的医疗保健的关注，了解全膝关节置换失败的原因势在必行。
