Salari Paolo, Baldini Andrea
Institute for Complex Arthroplasty and Revisions (ICAR), Villa Ulivella Clinic, Florence, Italy.
EFORT Open Rev. 2021 Jun 28;6(6):495-500. doi: 10.1302/2058-5241.6.210018. eCollection 2021 Jun.
Revision total knee arthroplasty (rTKA) is a challenging procedure with often unreproducible results. A step-by-step approach is fundamental to achieving good outcomes.Successful surgery requires a correct diagnosis of the original cause of failure. Only with an accurate and detailed plan can surgeons overcome difficulties presented in this scenario.Any bone loss should be prevented during prosthetic component removal. Efficient tools must be chosen to avoid time-consuming manoeuvres.Joint reconstruction based on a 'dual-zone' fixation is essential to provide a long-term survivorship of the implant. The use of relatively short fully cemented stems combined with a biological metaphyseal fixation is highly recommended by authors.Flexion and extension gaps are accurately balanced after the establishment of the tibial platform.Varus-valgus laxity is commonly managed with a condylar constrained prosthesis. If hinged implants are required, a stronger implant fixation is needed to counteract constraints forces. Cite this article: 2021;6:495-500. DOI: 10.1302/2058-5241.6.210018.
全膝关节置换翻修术（rTKA）是一项具有挑战性的手术，其结果往往难以重现。循序渐进的方法是取得良好疗效的根本。成功的手术需要正确诊断最初的失败原因。只有制定准确而详细的计划，外科医生才能克服这种情况下出现的困难。在移除假体组件时应防止任何骨质流失。必须选择高效的工具以避免耗时的操作。基于“双区”固定的关节重建对于确保植入物的长期存活至关重要。作者强烈推荐使用相对较短的全骨水泥柄并结合生物型干骺端固定。在建立胫骨平台后，精确平衡屈伸间隙。内翻-外翻松弛通常采用髁限制性假体进行处理。如果需要使用铰链式植入物，则需要更强的植入物固定以抵消限制力。引用本文：2021；6：495 - 500。DOI：10.1302/2058 - 5241.6.210018。
