Egloff Christian, Hirschmann Michael T, Moret Céline, Henle Philipp, Ellenrieder Martin, Tischer Thomas
Department of Orthopaedic Surgery and Traumatology, University Hospital Basel, Spitalstrasse 21/Petersgraben 4, 4031, Basel, Schweiz.
University of Basel, Basel, Schweiz.
Orthopade. 2021 May;50(5):395-401. doi: 10.1007/s00132-021-04104-w. Epub 2021 Apr 9.
The absolute number of total knee arthroplasties (TKA) continues to rise every year. About 10% of the patients are less than 55 years of age, although it is known that functional results and patient satisfaction are lower combined with an increased likelihood of revision compared to older patients. Higher physical activity and patient expectations are a major challenge in this age group. At the same time, the incidence of posttraumatic/postoperative alterations is high, including ligamentous or bony deficiencies, which can make the surgical procedure challenging. In view of these facts conservative treatments and joint sparing procedures should always be considered first. The potential correction of lower-limb deformities and unicompartmental knee arthroplasties need to be carefully evaluated before considering total knee arthroplasty. Only in advanced cases of osteoarthritis in more than one compartment of the knee of with combined ligamentous instability, can a TKA provide satisfactory results in the young patient. However, the strongest predictor of satisfaction is a realistic expectation.
全膝关节置换术（TKA）的绝对数量每年都在持续上升。约10%的患者年龄小于55岁，尽管众所周知，与老年患者相比，这一年龄段患者的功能结果和患者满意度较低，翻修可能性增加。较高的体力活动水平和患者期望是该年龄组面临的主要挑战。与此同时，创伤后/术后改变的发生率很高，包括韧带或骨质缺损，这可能使手术具有挑战性。鉴于这些事实，应始终首先考虑保守治疗和保留关节的手术。在考虑全膝关节置换术之前，需要仔细评估下肢畸形的潜在矫正和单髁膝关节置换术。只有在膝关节多个间室骨关节炎晚期或合并韧带不稳定的情况下，全膝关节置换术才能在年轻患者中提供满意的结果。然而，满意度的最强预测因素是现实的期望。
