Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, England.
King Edward VII's Hospital, 5-10 Beaumont Street, Marylebone, London, W1G 6AA, England.
J Orthop Surg Res. 2021 Dec 20;16(1):729. doi: 10.1186/s13018-021-02878-5.
Instability is one of the most common reasons for revision after a total knee replacement. It accounts for 17.4% of all single-stage revision procedures performed in the UK National Joint Registry. Through a careful patient evaluation, physical assessment and review of investigations one can identify the likely type of instability.
To critically examine the different types of instability, their presentation and evidence-based management options.
A comprehensive literature search was conducted to identify articles relevant to the aetiology and management of instability in total knee replacements.
Instability should be categorised as isolated or global and then, as flexion, mid-flexion, extension or recurvatum types. By identifying the aetiology of instability one can correctly restore balance and stability.
With careful judgement and meticulous surgical planning, instability can be addressed and revision surgery can provide patients with successful outcomes.
不稳定是全膝关节置换术后翻修的最常见原因之一。在英国国家关节登记处进行的所有单阶段翻修手术中，不稳定占 17.4%。通过仔细的患者评估、体格检查和检查回顾，可以确定可能的不稳定类型。
批判性地检查不同类型的不稳定、其表现和基于证据的管理选择。
进行了全面的文献检索，以确定与全膝关节置换术中不稳定的病因和管理相关的文章。
不稳定应分为孤立性或全身性，然后分为屈曲、中屈、伸展或后屈类型。通过确定不稳定的病因，可以正确恢复平衡和稳定性。
通过仔细的判断和细致的手术计划，可以解决不稳定问题，翻修手术可以为患者提供成功的结果。
