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[全膝关节置换术后膝关节伸展装置断裂的现状与治疗]

[Status and treatment of knee extension device disruption after total knee arthroplasty].

作者信息

Li Tiejian, Du Yinqiao, Sun Jingyang, Shen Junmin, Zhang Bohan, Zhou Yonggang

机构信息

Medical School of Chinese PLA, Beijing, 100853, P.R.China.

Department of Orthopedics, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Apr 15;35(4):502-507. doi: 10.7507/1002-1892.202010015.

Abstract

OBJECTIVE

To summarize the principle, classification, and treatment methods of knee extension device disruption after total knee arthroplasty (TKA).

METHODS

By extensively consulted the relevant domestic and abroad literature, the principle, classification, and treatment methods of injury according to different parts of the knee extension device after TKA were summarized and analyzed.

RESULTS

The knee extension device disruption after TKA mainly occurs in the quadriceps tendon, patella tendon, and patella. Once the knee extension device is injured, it will seriously affect the functional recovery of the patient after surgery, resulting in delayed knee extension, limited range of motion, difficulty walking, and joint pain, etc. The current treatment methods are diverse, including conservative treatment and surgical treatment. Surgical treatment includes direct suture repair (traditional perosseous fixation and suture anchoring techniques), reconstruction and reinforcement repair (reconstruction using synthetic patches, autografts, and allografts). For the treatment of different parts, it is necessary to comprehensively consider the patient's knee joint tissue condition, the presence or absence of underlying diseases, and the presence or absence of donors.

CONCLUSION

There is no uniform conclusion on the treatment of knee extension device disruption after TKA. Different injury situations need to be considered comprehensively to choose the appropriate treatment method.

摘要

目的

总结全膝关节置换术(TKA)后伸膝装置断裂的原理、分类及治疗方法。

方法

广泛查阅国内外相关文献,对TKA后伸膝装置不同部位损伤的原理、分类及治疗方法进行总结分析。

结果

TKA后伸膝装置断裂主要发生在股四头肌肌腱、髌腱及髌骨。伸膝装置一旦受损,将严重影响患者术后功能恢复,导致伸膝延迟、活动范围受限、行走困难及关节疼痛等。目前治疗方法多样,包括保守治疗和手术治疗。手术治疗包括直接缝合修复(传统骨内固定和缝线锚定技术)、重建及加强修复(使用合成补片、自体移植物和同种异体移植物进行重建)。针对不同部位的治疗,需综合考虑患者膝关节组织状况、有无基础疾病及有无供体等因素。

结论

TKA后伸膝装置断裂的治疗尚无统一结论。需综合考虑不同损伤情况以选择合适的治疗方法。

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本文引用的文献

1
Treatment of Extensor Tendon Disruption After Total Knee Arthroplasty: A Systematic Review.
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Extensor Mechanism Reconstruction with Use of Marlex Mesh: A Series Study of 77 Total Knee Arthroplasties.
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9
Synthetic Mesh Augmentation of Acute and Subacute Quadriceps Tendon Repair.
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Extensor mechanism allograft reconstruction for extensor mechanism failure following total knee arthroplasty.
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