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膝关节多韧带损伤手术重建的并发症:诊断、预防与治疗

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment.

作者信息

Rodríguez-Merchán E Carlos, De la Corte-Rodríguez Hortensia, Encinas-Ullán Carlos A, Gómez-Cardero Primitivo

机构信息

Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain.

Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Autonomous University of Madrid), Madrid, Spain.

出版信息

EFORT Open Rev. 2021 Oct 19;6(10):973-981. doi: 10.1302/2058-5241.6.210057. eCollection 2021 Oct.

Abstract

The main complications of surgical reconstruction of multiligament injuries of the knee joint are residual or recurrent instability, arthrofibrosis, popliteal artery injury, common peroneal nerve injury, compartment syndrome, fluid extravasation, symptomatic heterotopic ossification, wound problems and infection, deep venous thrombosis, and revision surgery.Careful surgical planning and execution of the primary surgical reconstruction of multiligament injuries of the knee joint can minimize the risk of the aforementioned complications.Careful postoperative follow-up is required to detect complications. Early recognition and prompt treatment are of paramount importance.To obtain good results in the revision surgery of failed multiligamentary knee reconstructions, it is crucial to perform a thorough and exhaustive evaluation to detect all the causes of failure.Addressing all associated injuries during revision surgery will lead to the best possible subjective and objective results, although functional outcomes are often modest.However, advanced age and high-energy injuries have been associated with the poorest functional outcomes after revision surgery of failed multiligament injuries of the knee joint. Cite this article: 2021;6:973-981. DOI: 10.1302/2058-5241.6.210057.

摘要

膝关节多韧带损伤手术重建的主要并发症包括残留或复发性不稳定、关节纤维性强直、腘动脉损伤、腓总神经损伤、骨筋膜室综合征、液体外渗、症状性异位骨化、伤口问题与感染、深静脉血栓形成以及翻修手术。对膝关节多韧带损伤进行细致的手术规划并实施初次手术重建,可将上述并发症的风险降至最低。术后需进行仔细的随访以发现并发症。早期识别和及时治疗至关重要。要在失败的膝关节多韧带重建翻修手术中取得良好效果,全面详尽地评估以发现所有失败原因至关重要。尽管功能结果往往一般,但在翻修手术中处理所有相关损伤将带来尽可能最佳的主观和客观结果。然而,高龄和高能损伤与膝关节多韧带损伤翻修手术后最差的功能结果相关。引用本文:2021;6:973 - 981。DOI: 10.1302/2058 - 5241.6.210057。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/685c/8559571/15ee1d11b143/eor-6-973-g001.jpg

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