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全膝关节置换术。

Conversion Total Knee Arthroplasty.

机构信息

Department of Orthopaedic Surgery, George Washington University, Washington, DC.

Adult Reconstruction Division, Department of Orthopaedic Surgery, Johns Hopkins University, Columbia, Maryland.

出版信息

JBJS Rev. 2021 Sep 9;9(9):01874474-202109000-00007. doi: e20.00198.

Abstract

»: Conversion total knee arthroplasty (TKA) represents a heterogeneous group of procedures and most commonly includes TKA performed after ligamentous reconstruction, periarticular open reduction and internal fixation (ORIF), high tibial osteotomy (HTO), and unicompartmental knee arthroplasty (UKA).

»: Relative to patients undergoing primary TKA, patients undergoing conversion TKA often have longer operative times and higher surgical complexity, which may translate into higher postoperative complication rates.

»: There is mixed evidence on implant survivorship and patient-reported outcome measures when comparing conversion TKA and primary TKA, with some studies noting no differences between the procedures and others finding decreased survivorship and outcome scores for conversion TKA.

»: By gaining an improved understanding of the unique challenges facing patients undergoing conversion TKA, clinicians may better set patient expectations, make intraoperative adjustments, and guide postoperative care.

摘要

»: 全膝关节置换术(TKA)的转换代表了一组异质的手术,最常见的包括韧带重建后、关节周围切开复位内固定(ORIF)、胫骨高位截骨术(HTO)和单髁膝关节置换术(UKA)后的 TKA。

»: 与接受初次 TKA 的患者相比,接受转换 TKA 的患者手术时间通常更长,手术复杂性更高,这可能转化为更高的术后并发症发生率。

»: 在比较转换 TKA 和初次 TKA 时,有关植入物存活率和患者报告的结果测量的证据存在差异,一些研究指出这两种手术之间没有差异,而其他研究则发现转换 TKA 的存活率和结果评分降低。

»: 通过更好地了解接受转换 TKA 的患者面临的独特挑战,临床医生可以更好地设定患者的期望、进行术中调整并指导术后护理。

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