Veeckmans P, Georis P, Thirion T
Service de Chirurgie de l'Appareil locomoteur, CHU Liège, Belgique.
Rev Med Liege. 2023 Jan;78(1):12-16.
Total knee replacement (TKR) is currently the gold standard in the surgical management of degenerative knee diseases. It is a reliable operation with 95 % good results at 10 years after surgery. Aseptic loosening is the primary cause of TKR failure. It results from a periprosthetic osteolytic reaction secondary to the host's reaction to the wear particle of the prosthesis and responsible for an imbalance in osteoformation and osteolysis. Polyethylene (PE) is responsible for the majority of periprosthetic reactions but the release of metal particles may play an underestimated role with the risk of systemic manifestations. The first clinical signs appear on average 7 years after prosthesis placement. Radio-clinical assessment may be normal in the early stages. Infectious process must be systematically excluded before concluding to another type of complication.
全膝关节置换术(TKR)目前是退行性膝关节疾病外科治疗的金标准。这是一种可靠的手术,术后10年有95%的良好效果。无菌性松动是TKR失败的主要原因。它是由假体磨损颗粒引起宿主反应继发的假体周围溶骨反应导致的,并且导致骨形成和骨溶解失衡。聚乙烯(PE)是大多数假体周围反应的原因,但金属颗粒的释放可能在全身表现风险方面起了被低估的作用。最初的临床症状平均在假体植入后7年出现。在早期,放射学临床评估可能正常。在诊断为其他类型并发症之前,必须系统地排除感染过程。