Department of Orthopaedic Surgery, George Washington University, Washington, DC.
Adult Reconstruction Division, Department of Orthopaedic Surgery, Johns Hopkins University, Columbia, Maryland.
JBJS Rev. 2021 Sep 9;9(9):01874474-202109000-00007. doi: e20.00198.
»: 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.
»: 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。