Popat Ravi, Tsitskaris Konstantinos, Millington Steven, Dawson-Bowling Sebastian, Hanna Sammy A
Department of Trauma and Orthopaedic Surgery, the Hillingdon Hospitals NHS Foundation Trust, Uxbridge UB8 3NN, United Kingdom.
Department of Trauma and Orthopaedic Surgery, Barts Health NHS Trust, London E1 1BB, United Kingdom.
World J Orthop. 2018 Oct 18;9(10):229-234. doi: 10.5312/wjo.v9.i10.229.
To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with Paget's disease of bone (PDB).
A systematic review of the literature was performed. Four studies with a total of 54 TKAs were included for analysis. Functional outcomes, pain scores, complications and revision rates were assessed. The mean age was 72.0 years and the mean follow-up was 7.5 years.
All studies reported significant improvement in knee function and pain scores following TKA. There were 2 cases of aseptic loosening, with one patient requiring revision of the femoral component 10 years after the index procedure. Malalignment, bone loss, soft tissue contractures were the most commonly reported intra-operative challenges. There were five cases (9%) that were complicated by intra-operative patellar tendon avulsion.
The findings support the use of TKA in patients with PDB. The post-operative functional outcomes are largely similar to other patients, however there are specific perioperative challenges that have been highlighted, in particular the high risk for patellar tendon avulsion.
确定骨Paget病（PDB）患者全膝关节置换术（TKA）后的功能结局、并发症及翻修率。
对文献进行系统综述。纳入四项研究，共54例TKA进行分析。评估功能结局、疼痛评分、并发症及翻修率。平均年龄为72.0岁，平均随访时间为7.5年。
所有研究均报告TKA后膝关节功能和疼痛评分有显著改善。有2例无菌性松动，其中1例患者在初次手术后10年需要翻修股骨部件。对线不良、骨丢失、软组织挛缩是最常报告的术中挑战。有5例（9%）发生术中髌腱撕脱并发症。
研究结果支持对PDB患者使用TKA。术后功能结局在很大程度上与其他患者相似，然而已突出显示了特定的围手术期挑战，特别是髌腱撕脱的高风险。
