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一名有多次膝关节手术史患者的成功膝关节置换:病例报告

Successful Knee Replacement in a Patient With a History of Multiple Knee Surgeries: A Case Report.

作者信息

Patil Ishiqua V, Sharma Prerit, Salwan Ankur, Khan Khizar K, Pisulkar Gajanan

机构信息

Hospital Administration, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jun 28;16(6):e63355. doi: 10.7759/cureus.63355. eCollection 2024 Jun.

Abstract

This case report describes the successful total knee arthroplasty (TKA) in a 58-year-old female with a prior history of multiple knee surgeries. The patient had three prior surgical procedures. The first surgery of the patient was a partial knee replacement, the second surgery the patient underwent was an arthroscopic meniscectomy, and the third surgery was a high tibial osteotomy (HTO) that left her with an extensive amount of scar tissue and a change in physical structure. When scar tissue develops over or close to a joint, the surrounding tissues are pulled inward by this shrinking or contraction. A joint may experience restricted movement as a result of this tightness. Stretchy and excessively flexible joints are common in people with Ehlers-Danlos syndrome. This may become an issue if you need sutures for a wound because the skin is frequently not strong enough to support them. The patient already undergone three surgeries prior but still showed signs of severe pain, swelling, and stiffness in the knee which made the patient suffer more during rest position and also made it sometimes so difficult that it affected everyday tasks. In this situation when the patient consulted the doctors, the patient was suggested to undergo TKA. TKA is the method of orthopedic surgical technique that is most consistently successful and highly effective. Patients with end-stage degenerative knee osteoarthritis might expect reliable results from this surgery. The case demonstrates the preoperative planning, surgical methods, and postoperative care needed to successfully treat a complicated patient profile. Hospital protocols were followed, and the patient's surgery was done with proper care and hygiene.

摘要

本病例报告描述了一名58岁女性成功进行全膝关节置换术(TKA)的过程,该患者既往有多次膝关节手术史。患者之前接受过三次手术。第一次手术是部分膝关节置换,第二次手术是关节镜下半月板切除术,第三次手术是高位胫骨截骨术(HTO),这使她留下了大量瘢痕组织,身体结构也发生了改变。当瘢痕组织在关节上方或附近形成时,周围组织会因这种收缩而向内牵拉。由于这种紧绷,关节可能会出现活动受限。埃勒斯-当洛综合征患者常见关节松弛且过度灵活。如果伤口需要缝合,这可能会成为一个问题,因为皮肤往往不够坚韧来支撑缝线。该患者之前已经接受过三次手术,但膝关节仍有严重疼痛、肿胀和僵硬的症状,这使患者在休息时更加痛苦,有时甚至影响日常活动。在这种情况下,患者咨询医生后,被建议进行全膝关节置换术。全膝关节置换术是最持续成功且高效的骨科手术技术。终末期退行性膝关节骨关节炎患者可能期望通过该手术获得可靠的效果。该病例展示了成功治疗复杂患者情况所需的术前规划、手术方法和术后护理。医院遵循了相关规程,患者的手术在适当的护理和卫生条件下完成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd11/11283917/cc8dd4121eaf/cureus-0016-00000063355-i01.jpg

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