翻修全膝关节置换术的平衡与限制：不稳定处理的分类
Balance and constraint in revision TKR: A classification for instability management.
作者信息
Morgan-Jones Rhidian, Graichen Heiko
机构信息
University Hospital Llandough, Cardiff, CF64 2XX, UK.
Orthopaedic Hospital Lindenlohe, Lindenlohe 18, 92421, Schwandorf, Germany.
出版信息
J Orthop. 2021 Feb 4;24:19-25. doi: 10.1016/j.jor.2021.01.016. eCollection 2021 Mar-Apr.
UNLABELLED
Instability is an increasingly common cause and symptom of failure of Total Knee Arthroplasty (TKA). Patients seek 'Functional Stability', which is the sum of both a balanced joint and, if necessary, mechanical constraint. The objective of this paper is to classify the different types of TKA instability and their causes. Based on this classification, the authors give methodical recommendations for instability management.
INSTABILITY CLASSIFICATION
Instability in revision TKA can be classified into 3 types based on the management of bone loss and ligamentous deficiency which directs the level of constraint required to achieve functional stability.
TYPE 1: Bone deficiency: Revision with restoration of joint line and rebuilding the bony anatomy results in a balanced joint. No increased constraint is needed.
TYPE 2: Ligament and soft tissue deficiency: Requires increased constraint to overcome instability.
TYPE 3: Composite (Total) deficiency: (combined Type 1 and 2).The multiple causes of instability are outlined for each Instability type along with an algorithm for restoring the joint line and adding titrated constraint to restore functional stability.
未标注
不稳定是全膝关节置换术（TKA）失败日益常见的原因和症状。患者追求“功能稳定性”，这是平衡关节以及必要时机械约束的总和。本文的目的是对TKA不同类型的不稳定及其原因进行分类。基于此分类，作者给出了处理不稳定的系统性建议。
不稳定分类
翻修TKA中的不稳定可根据骨丢失和韧带缺损的处理方法分为3种类型，这决定了实现功能稳定性所需的约束水平。
1型：骨缺损：通过恢复关节线和重建骨解剖结构进行翻修可实现平衡关节。无需增加约束。
2型：韧带和软组织缺损：需要增加约束以克服不稳定。
3型：复合（完全）缺损：（1型和2型的组合）。针对每种不稳定类型概述了不稳定的多种原因，以及恢复关节线和添加适当约束以恢复功能稳定性的算法。
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