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感染性全膝关节置换术后行膝关节融合术患者的功能结局

Functional Outcome of Patients Undergoing Knee Arthrodesis after Infected Total Arthroplasty.

作者信息

Vivacqua Thiago, Moraes Rui, Barretto João, Cavanelas Naasson, Albuquerque Rodrigo, Mozella Alan

机构信息

Instituto Nacional de Traumatologia e Ortopedia Jamill Haddad, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Jun;56(3):320-325. doi: 10.1055/s-0040-1709198. Epub 2020 Jun 10.

Abstract

Retrospectively assess the functional outcome of patients undergoing arthrodesis after septic failure of total knee arthroplasty.  Eighteen patients were evaluated, with a mean time of 3.7 years of follow-up. Arthrodesis surgery was performed using a narrow anterior dynamic compression plate, and medial or external fixator in two planes of the joint (Orthofix Bone Growth Therapy, Lewisville, TS, USA), at the surgeon's discretion.  The most frequent pathogen found was methicillin sensitive (38.9%). The mean lower limb discrepancy was 3.63 cm. The mean knee society score was 68 points. According to the visual analog scale for pain, 44% of the patients had a 0 score at the time of assessment, and 22.2% were very dissatisfied, despite the bone healing achieved. Patients were assessed for the ability to walk with or without assistance.  Knee arthrodesis surgery was effective in controlling the infectious process and decreasing pain complaints, but satisfaction with the procedure was low.

摘要

回顾性评估全膝关节置换术后感染失败而行关节融合术患者的功能结局。对18例患者进行了评估,平均随访时间为3.7年。关节融合术采用窄型前侧动力加压钢板,或根据外科医生的判断在关节的两个平面使用内侧或外固定器(美国德克萨斯州刘易斯维尔市的奥索夫固定骨生长治疗公司)进行。最常见的病原体是对甲氧西林敏感的(38.9%)。下肢平均长度差异为3.63厘米。膝关节协会平均评分为68分。根据疼痛视觉模拟量表,44%的患者在评估时评分为0分,22.2%的患者非常不满意,尽管已实现骨愈合。评估了患者在有无辅助情况下的行走能力。膝关节融合术在控制感染过程和减少疼痛主诉方面有效,但患者对该手术的满意度较低。

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