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单髁膝关节置换术失败与翻修的研究进展

[Research progress of failure and revision of unicompartmental knee arthroplasty].

作者信息

Guo Shuxin, Guan Shikun, Liu Ning

机构信息

Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150001, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Feb 15;37(2):221-227. doi: 10.7507/1002-1892.202211013.

DOI:10.7507/1002-1892.202211013
PMID:36796820
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9970781/
Abstract

OBJECTIVE

To conclude the failure factors of unicompartmental knee arthroplasty (UKA), and summarize the research progress of revision surgery.

METHODS

The literature on UKA at home and abroad in recent years was reviewed to summarize its risk factors, treatment methods, including the evaluation of bone loss, prosthesis selection, and surgical techniques.

RESULTS

The factors inducing UKA failure mainly include improper indications, technical errors, and others. The application of digital orthopedic technology can reduce failures caused by surgical technical errors and shorten the learning curve. There are a variety of options for revision surgery after UKA failure, including polyethylene liner replacement, revision with UKA or total knee arthroplasty, with adequate preoperative evaluation prior to implementation. The biggest challenge in revision surgery is the management and reconstruction of bone defects.

CONCLUSION

There is a risk of failure in UKA, which needs to be treated with caution and should be determined according to the type of failure.

摘要

目的

总结单髁膝关节置换术(UKA)的失败因素,并综述翻修手术的研究进展。

方法

回顾近年来国内外关于UKA的文献,总结其危险因素、治疗方法,包括骨丢失评估、假体选择及手术技术。

结果

导致UKA失败的因素主要包括适应证选择不当、技术失误等。数字骨科技术的应用可减少手术技术失误导致的失败,并缩短学习曲线。UKA失败后的翻修手术有多种选择,包括聚乙烯衬垫置换、采用UKA或全膝关节置换进行翻修,实施前需进行充分的术前评估。翻修手术最大的挑战是骨缺损的处理与重建。

结论

UKA存在失败风险,需谨慎对待,应根据失败类型确定治疗方案。

相似文献

1
[Research progress of failure and revision of unicompartmental knee arthroplasty].单髁膝关节置换术失败与翻修的研究进展
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2
Do bone loss and reconstruction procedures differ at revision of cemented unicompartmental knee prostheses according to the use of metal-back or all-polyethylene tibial component?翻修骨水泥型单间室膝关节假体时,使用金属后壳或全聚乙烯胫骨组件是否会影响骨质丢失和重建过程?
Orthop Traumatol Surg Res. 2013 Oct;99(6):687-92. doi: 10.1016/j.otsr.2013.03.018. Epub 2013 Jun 28.
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[APPLICATION OF COMPUTER-ASSISTED TECHNOLOGY IN ANALYSIS OF REVISION REASON OF UNICOMPARTMENTAL KNEE ARTHROPLASTY].[计算机辅助技术在单髁膝关节置换翻修原因分析中的应用]
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Jan;30(1):119-22.
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Bearing thickness of unicompartmental knee arthroplasty is a reliable predictor of tibial bone loss during revision to total knee arthroplasty.单髁膝关节置换术中的衬垫厚度是翻修为全膝关节置换术中胫骨骨丢失的可靠预测指标。
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J ISAKOS. 2022 Oct;7(5):132-141. doi: 10.1016/j.jisako.2022.06.001. Epub 2022 Jun 28.
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Lateral unicompartmental knee replacement for the treatment of arthritis progression after medial unicompartmental replacement.外侧单髁膝关节置换术治疗内侧单髁置换术后关节炎进展
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Clinical outcomes and patient satisfaction following revision of failed unicompartmental knee arthroplasty to total knee arthroplasty are as good as a primary total knee arthroplasty.将失败的单髁膝关节置换术翻修为全膝关节置换术后的临床结果和患者满意度与初次全膝关节置换术一样好。
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J Arthroplasty. 2017 Oct;32(10):3228-3237.e2. doi: 10.1016/j.arth.2017.04.063. Epub 2017 May 11.

本文引用的文献

1
Referencing the Tibial Plateau With a Probe Improves the Accuracy of the Posterior Slope in Medial Unicompartmental Knee Arthroplasty.使用探针参照胫骨平台可提高内侧单髁膝关节置换术中后倾角的准确性。
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Treatment patterns and failure rates associated with prosthetic joint infection in unicompartmental knee arthroplasty: A systematic review.单髁膝关节置换术中人工关节感染的治疗模式及失败率:一项系统评价
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Anterior cruciate ligament deficiency versus intactness for outcomes in patients after unicompartmental knee arthroplasty: a systematic review and meta-analysis.单髁膝关节置换术后患者前交叉韧带缺损与完整状态对预后的影响:一项系统评价与荟萃分析
Front Bioeng Biotechnol. 2022 Aug 23;10:890118. doi: 10.3389/fbioe.2022.890118. eCollection 2022.
4
The lifetime revision risk of unicompartmental knee arthroplasty.单髁膝关节置换术的终身翻修风险。
Bone Joint J. 2022 Jun;104-B(6):672-679. doi: 10.1302/0301-620X.104B6.BJJ-2021-1744.R1.
5
Potential factors in postoperative dislocation of Oxford phase III mobile bearing UKA in Chinese patients: a single-center retrospective study.中国患者牛津三期活动平台 UKA 术后脱位的潜在因素:单中心回顾性研究。
BMC Musculoskelet Disord. 2021 Nov 8;22(1):930. doi: 10.1186/s12891-021-04828-y.
6
Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre.在非设计中心,骨水泥型牛津 3 期单髁膝关节置换术具有良好的中期至长期效果。
Knee Surg Sports Traumatol Arthrosc. 2022 Sep;30(9):3215-3219. doi: 10.1007/s00167-021-06665-x. Epub 2021 Jul 12.
7
Incidence, temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96,294 knees.初次单髁膝关节置换术后无菌性松动的发生率、时间趋势及潜在危险因素:对96,294例膝关节的荟萃分析
Knee. 2021 Aug;31:28-38. doi: 10.1016/j.knee.2021.04.005. Epub 2021 Jun 7.
8
Revision indications for medial unicompartmental knee arthroplasty: a systematic review.内侧单髁膝关节置换术的翻修指征:一项系统评价
Arch Orthop Trauma Surg. 2022 Feb;142(2):301-314. doi: 10.1007/s00402-021-03827-x. Epub 2021 Feb 25.
9
Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis.东亚国家活动垫片式单髁膝关节置换术后的假体脱位:系统评价与荟萃分析。
J Orthop Surg Res. 2021 Jan 7;16(1):28. doi: 10.1186/s13018-020-02190-8.
10
Unicompartmental knee arthroplasty is associated with lower proportions of surgical site infection compared with total knee arthroplasty: A retrospective nationwide database study.与全膝关节置换术相比,单髁膝关节置换术的手术部位感染比例更低:一项全国性回顾性数据库研究。
Knee. 2021 Jan;28:124-130. doi: 10.1016/j.knee.2020.11.017. Epub 2020 Dec 23.