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牛津内侧单髁膝关节置换术后睡眠翻身时半月板假体脱位

Meniscal bearing dislocation while rolling over in sleep following Oxford medial unicompartmental knee arthroplasty.

作者信息

Kawaguchi Kohei, Inui Hiroshi, Taketomi Shuji, Yamagami Ryota, Kono Kenichi, Nakazato Keiu, Kawata Manabu, Tanaka Sakae

机构信息

The University of Tokyo Hospital, Orthopaedic surgery, Tokyo, Japan.

The University of Tokyo Hospital, Orthopaedic surgery, Tokyo, Japan.

出版信息

Knee. 2019 Jan;26(1):267-272. doi: 10.1016/j.knee.2018.10.015. Epub 2018 Dec 14.

Abstract

Meniscal bearing dislocation while rolling over in sleep has never been reported in Oxford unicompartmental knee arthroplasty (UKA). This study reports two cases of meniscal bearing dislocation into the intercondylar ridge while rolling over in sleep. In the case of one patient, closed reduction of the bearing was performed, and the use of a knee brace was effective in preventing re-dislocation. In the second patient, closed reduction was possible; however, bearing dislocation was repeated. Therefore, revision surgery was performed by replacing the tibial component and using a thicker bearing. The common features in dislocation during rolling over while sleeping in both cases were dislocation into the intercondylar ridge, the combination of small femur and AA-size tibia components, and osteonecrosis. As determined by intraoperative testing, valgus position of the knee while rolling over in sleep could induce bearing dislocation into the intercondylar ridge. LEVEL OF EVIDENCE: Retrospective case series, Level IV.

摘要

在牛津单髁膝关节置换术(UKA)中,睡眠翻身时半月板假体脱位的情况此前从未有过报道。本研究报告了两例睡眠翻身时半月板假体脱位至髁间嵴的病例。其中一例患者,对假体进行了闭合复位,使用膝关节支具有效防止了再次脱位。第二例患者也可行闭合复位;然而,假体脱位反复发生。因此,通过更换胫骨组件并使用更厚的假体进行了翻修手术。两例患者睡眠翻身时脱位的共同特征为脱位至髁间嵴、小尺寸股骨和AA尺寸胫骨组件的组合以及骨坏死。术中测试表明,睡眠翻身时膝关节的外翻位可导致半月板假体脱位至髁间嵴。证据级别:回顾性病例系列,IV级。

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