全膝关节置换翻修术的结果（综述）
Outcomes in revision total knee arthroplasty (Review).
作者信息
Roman Mihai Dan, Russu Octav, Mohor Calin, Necula Radu, Boicean Adrian, Todor Adrian, Mohor Cosmin, Fleaca Sorin Radu
机构信息
Department of Orthopedic and Trauma Surgery, 'Lucian Blaga' University, 550276 Sibiu, Romania.
Department of Orthopedic Surgery, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania.
出版信息
Exp Ther Med. 2022 Jan;23(1):29. doi: 10.3892/etm.2021.10951. Epub 2021 Nov 8.
Abstract
Revision total knee arthroplasty (TKA) is a challenging surgical procedure. Although good results are presented, the outcomes are worse in comparison with those of primary TKA, with a higher failure rate. The main reasons for the failure of revision TKA include: sepsis, loosening and instability. There are multiple variables linked to these results, and it is difficult to determinate the exact cause as it is often a multifactorial issue. These variables may be related to the quality of the index-procedure (TKA), to the revision procedure or to patient characteristics. The purpose of this review was to highlight the outcomes of revision knee arthroplasty and main factors that may influence the results. Considerable progress has been made during the last 30 years regarding infection treatment and prevention, complex revision prosthetic design and surgical technique development. Although the outcomes have improved over time, patients who undergo revision TKA may need further re-operations in the future.
摘要
全膝关节置换翻修术（TKA）是一项具有挑战性的外科手术。尽管有良好的结果报道，但与初次全膝关节置换术相比，其结果更差，失败率更高。全膝关节置换翻修术失败的主要原因包括：感染、假体松动和不稳定。有多个变量与这些结果相关，很难确定确切原因，因为这往往是一个多因素问题。这些变量可能与初次手术（全膝关节置换术）的质量、翻修手术或患者特征有关。本综述的目的是强调膝关节置换翻修术的结果以及可能影响结果的主要因素。在过去30年中，在感染治疗与预防、复杂翻修假体设计和手术技术发展方面取得了相当大的进展。尽管随着时间推移结果有所改善，但接受全膝关节置换翻修术的患者未来可能仍需要进一步的再次手术。
相似文献
1
Outcomes in revision total knee arthroplasty (Review).全膝关节置换翻修术的结果（综述）
Exp Ther Med. 2022 Jan;23(1):29. doi: 10.3892/etm.2021.10951. Epub 2021 Nov 8.
2
What Are the All-Cause Survivorship Rates and Functional Outcomes in Patients Younger Than 55 Years Undergoing Primary Knee Arthroplasty? A Systematic Review.55 岁以下初次膝关节置换患者的全因生存率和功能结局如何？一项系统评价。
Clin Orthop Relat Res. 2022 Mar 1;480(3):507-522. doi: 10.1097/CORR.0000000000002023.
3
Outcomes of Unicompartmental Knee Arthroplasty After Aseptic Revision to Total Knee Arthroplasty: A Comparative Study of 768 TKAs and 578 UKAs Revised to TKAs from the Norwegian Arthroplasty Register (1994 to 2011).无菌性翻修为全膝关节置换术后单髁膝关节置换术的结果：一项对挪威关节置换登记处（1994年至2011年）768例全膝关节置换术和578例翻修为全膝关节置换术的单髁膝关节置换术的比较研究。
J Bone Joint Surg Am. 2016 Mar 16;98(6):431-40. doi: 10.2106/JBJS.O.00499.
4
Revision of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty: Is It as Good as a Primary Result?单髁膝关节置换翻修为全膝关节置换：其结果是否与初次置换一样好？
J Arthroplasty. 2018 Jul;33(7S):S105-S108. doi: 10.1016/j.arth.2018.03.023. Epub 2018 Mar 17.
5
Good to excellent long-term survival of a single-design condylar constrained knee arthroplasty for primary and revision surgery.单髁限制型膝关节置换术治疗初次和翻修手术的优良长期生存率。
Knee Surg Sports Traumatol Arthrosc. 2022 Sep;30(9):3184-3190. doi: 10.1007/s00167-021-06636-2. Epub 2021 Jun 14.
6
Knee instability as the primary cause of failure following Total Knee Arthroplasty (TKA): A systematic review on the patient, surgical and implant characteristics of revised TKA patients.膝关节不稳作为全膝关节置换术（TKA）失败的主要原因：对翻修TKA患者的患者、手术及植入物特征的系统评价
Knee. 2017 Dec;24(6):1271-1281. doi: 10.1016/j.knee.2017.08.060. Epub 2017 Sep 29.
7
Have the frequency of and reasons for revision total knee arthroplasty changed since 2000? Comparison of two cohorts from the same hospital: 255 cases (2013-2016) and 68 cases (1991-1998).自 2000 年以来，全膝关节置换术的修订频率和原因是否发生了变化？对同一医院的两个队列进行比较：255 例（2013-2016 年）和 68 例（1991-1998 年）。
Orthop Traumatol Surg Res. 2019 Jun;105(4):639-645. doi: 10.1016/j.otsr.2019.01.025. Epub 2019 May 11.
8
Good Mid-Term Implant Survival of a Novel Single-Design Rotating-Hinge Total Knee Arthroplasty.新型单设计旋转铰链全膝关节置换术的中期植入物良好存活率
J Clin Med. 2023 Sep 22;12(19):6113. doi: 10.3390/jcm12196113.
9
Trend Shift in the Cause of Revision Total Knee Arthroplasty over 17 Years.翻修全膝关节置换术病因的趋势变化：17 年回顾研究
Clin Orthop Surg. 2023 Apr;15(2):219-226. doi: 10.4055/cios21106. Epub 2022 Jun 30.
10
Complications and failures of non-tumoral hinged total knee arthroplasty in primary and aseptic revision surgery: A review of 290 cases.非肿瘤铰链式全膝关节置换术在初次和无菌翻修手术中的并发症和失败：290 例回顾。
Orthop Traumatol Surg Res. 2021 May;107(3):102875. doi: 10.1016/j.otsr.2021.102875. Epub 2021 Feb 27.
引用本文的文献
1
3D printed CNT/TPU triboelectric nanogenerator for load monitoring of total knee replacement.用于全膝关节置换负荷监测的3D打印碳纳米管/热塑性聚氨酯摩擦纳米发电机
Smart Mater Struct. 2025 Jun 1;34(6):065030. doi: 10.1088/1361-665X/ade1ba. Epub 2025 Jun 19.
2
SPECT/CT and triple-phase bone scan: A valuable diagnostic approach for identifying indications for secondary patellar resurfacing in patients with unexplained anterior knee pain post-TKA.单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）与三相骨扫描：一种用于确定全膝关节置换术后不明原因前膝痛患者二次髌骨表面置换指征的有价值的诊断方法。
Arthroplasty. 2025 Apr 2;7(1):15. doi: 10.1186/s42836-025-00300-7.
3
Is the Effect of Chronological Age on Postoperative Complications Related to Comorbidity Burden? A Population Study of Revision Total Knee Arthroplasty Patients.实际年龄对与共病负担相关的术后并发症的影响如何？一项全膝关节置换翻修术患者的人群研究。
J Am Acad Orthop Surg Glob Res Rev. 2025 Feb 11;9(2). doi: 10.5435/JAAOSGlobal-D-24-00266. eCollection 2025 Feb 1.
4
Reliability and utility of the new Belt et al. classification for revision of infected total knee arthroplasty.用于感染性全膝关节置换翻修的Belt等人新分类法的可靠性和实用性
Arch Orthop Trauma Surg. 2025 Feb 1;145(1):155. doi: 10.1007/s00402-025-05769-0.
5
Stem fixation techniques in revision total knee arthroplasty: A systematic review and meta-analysis.翻修全膝关节置换术中的股骨柄固定技术：一项系统评价和荟萃分析。
J Exp Orthop. 2025 Jan 9;12(1):e70086. doi: 10.1002/jeo2.70086. eCollection 2025 Jan.
6
Leveraging transfer learning for predicting total knee arthroplasty failure from post-operative radiographs.利用迁移学习从术后X光片预测全膝关节置换术失败情况。
J Exp Orthop. 2024 Dec 11;11(4):e70097. doi: 10.1002/jeo2.70097. eCollection 2024 Oct.
7
Influence of Diabetes Mellitus on Postoperative Complications After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.糖尿病对全膝关节置换术后并发症的影响：系统评价和荟萃分析。
Medicina (Kaunas). 2024 Oct 26;60(11):1757. doi: 10.3390/medicina60111757.
8
[Unicondylar knee arthroplasties demonstrate a significantly increased risk of aseptic revisions compared with unconstrained and constrained TKA : Analysis of aseptic revisions after unicondylar and primary total knee arthroplasty of the German Arthroplasty Register].[与非限制性和限制性全膝关节置换术相比，单髁膝关节置换术无菌翻修风险显著增加：德国关节置换登记处单髁膝关节置换术和初次全膝关节置换术后无菌翻修分析]
Orthopadie (Heidelb). 2024 Oct;53(10):789-798. doi: 10.1007/s00132-024-04561-z. Epub 2024 Sep 23.
9
Knee osteoarthritis: disease burden, available treatments, and emerging options.膝骨关节炎：疾病负担、现有治疗方法及新出现的选择
Ther Adv Musculoskelet Dis. 2024 Sep 15;16:1759720X241273009. doi: 10.1177/1759720X241273009. eCollection 2024.
10
Impact of systemic lupus erythematosus (SLE) on outcomes following aseptic and septic revision total knee arthroplasty: an analysis of the 2005-2018 nationwide inpatient sample.红斑狼疮性关节炎（SLE）对无菌性和感染性全膝关节翻修术后结局的影响：对 2005-2018 年全国住院患者样本的分析。
Clin Rheumatol. 2024 Oct;43(10):3127-3137. doi: 10.1007/s10067-024-07098-w. Epub 2024 Aug 13.
本文引用的文献
1
Reasons for revision are associated with rerevised total knee arthroplasties: an analysis of 8,978 index revisions in the Dutch Arthroplasty Register.翻修原因与再次全膝关节置换术有关：荷兰关节置换登记处 8978 例指数翻修的分析。
Acta Orthop. 2021 Oct;92(5):597-601. doi: 10.1080/17453674.2021.1925036. Epub 2021 May 14.
2
A finite element analysis for predicting outcomes of cemented total knee arthroplasty.一种用于预测骨水泥型全膝关节置换术结果的有限元分析。
Exp Ther Med. 2021 Mar;21(3):267. doi: 10.3892/etm.2021.9698. Epub 2021 Jan 25.
3
Is Dual Antibiotic-Loaded Bone Cement More Effective and Cost-Efficient Than a Single Antibiotic-Loaded Bone Cement to Reduce the Risk of Prosthetic Joint Infection in Aseptic Revision Knee Arthroplasty?在无菌翻修膝关节置换术中，双载抗生素骨水泥与单载抗生素骨水泥相比，降低假体关节感染风险的效果和成本效益如何？
J Arthroplasty. 2020 Dec;35(12):3724-3729. doi: 10.1016/j.arth.2020.06.045. Epub 2020 Jun 20.
4
Risk assessment of antibiotic resistance development by antibiotic-loaded bone cements: is it a clinical concern?载抗生素骨水泥导致抗生素耐药性产生的风险评估：这是一个临床问题吗？
EFORT Open Rev. 2019 Oct 11;4(10):576-584. doi: 10.1302/2058-5241.4.180104. eCollection 2019 Oct.
5
Revision total knee arthroplasty (TKA): mid-term outcomes and bone loss/quality evaluation and treatment.翻修全膝关节置换术（TKA）：中期结果和骨丢失/质量评估及治疗。
J Orthop Surg Res. 2019 Aug 28;14(1):280. doi: 10.1186/s13018-019-1328-1.
6
Periprosthetic Infection: Major Cause of Early Failure of Primary and Revision Total Knee Arthroplasty.人工关节周围感染：初次及翻修全膝关节置换早期失败的主要原因
J Knee Surg. 2019 Oct;32(10):941-946. doi: 10.1055/s-0038-1672203. Epub 2018 Oct 18.
7
Revision total knee arthroplasty: hybrid vs standard cemented fixation.全膝关节置换翻修术：混合式与标准骨水泥固定
J Orthop Traumatol. 2018 Aug 17;19(1):9. doi: 10.1186/s10195-018-0494-y.
8
What Is the Impact of Smoking on Revision Total Knee Arthroplasty?吸烟对全膝关节翻修术的影响有哪些？
J Arthroplasty. 2018 Jul;33(7S):S172-S176. doi: 10.1016/j.arth.2018.03.024. Epub 2018 Mar 17.
9
Type 2 diabetes and in-hospital complications after revision of total hip and knee arthroplasty.全髋关节和膝关节置换翻修术后的2型糖尿病与院内并发症
PLoS One. 2017 Aug 24;12(8):e0183796. doi: 10.1371/journal.pone.0183796. eCollection 2017.
10
Causes and Clinical Outcomes of Revision Total Knee Arthroplasty.全膝关节置换翻修术的病因及临床结果
Knee Surg Relat Res. 2017 Jun 1;29(2):104-109. doi: 10.5792/ksrr.16.035.
Zotero 插件