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切除关节成形术作为全膝关节置换术后感染膝关节的挽救性手术。

Resection arthroplasty as a salvage procedure for a knee with infection after a total arthroplasty.

作者信息

Falahee M H, Matthews L S, Kaufer H

机构信息

Section of Orthopaedic Surgery, University Hospital, Ann Arbor, Michigan 48109-0328.

出版信息

J Bone Joint Surg Am. 1987 Sep;69(7):1013-21.

PMID:3654692
Abstract

Between 1970 and 1983, resection arthroplasty was done as a salvage procedure for twenty-eight knees (twenty-six patients) with infection after total arthroplasty. Eleven patients had multiarticular rheumatoid arthritis; fourteen, osteoarthritis; and one, multiarticular neuropathic arthropathy. Systemic signs of infection were eliminated in all patients and local signs, in 89 per cent of the patients. After resection arthroplasty alone, fifteen patients were able to walk independently. Six patients with monoarticular osteoarthritis who found the resection arthroplasty to be unacceptable had a successful secondary arthrodesis. In three patients a spontaneous bone fusion developed after the resection, with the knee in a good position. Two patients who were unable to walk before the resection arthroplasty were still unable to do so postoperatively. Neither the patient's disease nor the type of prosthesis that had been used was a reliable predictor of success of the resection arthroplasty. The patients who had had the most severe disability before the total knee arthroplasty were most likely to be satisfied. Patients who had had less disability were more likely to find the results of resection arthroplasty to be unsatisfactory.

摘要

1970年至1983年间,对28个膝关节(26例患者)进行了切除关节成形术,作为全关节置换术后感染的挽救手术。11例患者患有多关节类风湿性关节炎;14例患有骨关节炎;1例患有多关节神经性关节病。所有患者的全身感染症状均消除,89%的患者局部症状消除。仅行切除关节成形术后,15例患者能够独立行走。6例单关节骨关节炎患者认为切除关节成形术不可接受,二次关节固定术成功。3例患者在切除术后出现自发骨融合,膝关节位置良好。2例在切除关节成形术前无法行走的患者术后仍无法行走。患者的疾病以及所使用的假体类型均不是切除关节成形术成功的可靠预测指标。全膝关节置换术前残疾最严重的患者最有可能感到满意。残疾程度较轻的患者更有可能认为切除关节成形术的结果不理想。

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