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旋转铰链式膝关节假体治疗夏科氏关节炎:病例报告及文献复习。

Rotation-hinged knee prosthesis for the treatment of Charcot arthropathy: a case report and literature review.

机构信息

Research Institute of Orthopedics, The Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China.

出版信息

J Int Med Res. 2021 Nov;49(11):3000605211058871. doi: 10.1177/03000605211058871.

Abstract

Charcot arthropathy is a type of destructive osteoarthropathy characterized by neurotrophic and sensory disorders. The condition is relatively rare, with an insidious onset, and it is easily misdiagnosed. Total knee arthroplasty (TKA) can cause excessive joint wear, continuous inflammatory stimulation of the prosthesis, postoperative residual cavity, prosthesis loosening and subsidence, peripheral fracture, infection, and other complications. Furthermore, these complications are more likely to occur in patients with Charcot arthropathy because of disease-specific pathological characteristics, when TKA is performed. Therefore, Charcot arthropathy was once a contraindication to TKA. Recently, with the optimization of joint prostheses and the maturity of surgical techniques, more studies have reported successful cases of TKA in patients with Charcot arthropathy. We report a case of Charcot arthropathy in our hospital, and describe the patient's medical history, clinical symptoms, signs, imaging findings, diagnosis, and the entire TKA process, to explore the TKA strategy and prosthesis selection in a patient with Charcot arthropathy.

摘要

夏科氏关节病是一种破坏性的骨关节炎,其特征为神经营养和感觉障碍。这种疾病相对罕见,起病隐匿,容易误诊。全膝关节置换术(TKA)可导致关节过度磨损、假体持续炎症刺激、术后残余腔、假体松动和下沉、周围骨折、感染等并发症。此外,由于疾病的特定病理特征,这些并发症在患有夏科氏关节病的患者中更容易发生,当进行 TKA 时。因此,夏科氏关节病曾经是 TKA 的禁忌证。最近,随着关节假体的优化和手术技术的成熟,越来越多的研究报告了夏科氏关节病患者 TKA 的成功病例。我们报告了我院的 1 例夏科氏关节病病例,描述了患者的病史、临床症状、体征、影像学发现、诊断以及整个 TKA 过程,以探讨夏科氏关节病患者 TKA 的策略和假体选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/994c/8649473/6da22a9c92fd/10.1177_03000605211058871-fig1.jpg

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