Mozella Alan de Paula, Cobra Hugo Alexandre de Araújo Barros, Minamoto Sandra Tie Nishibe, Salim Rodrigo, Leal Ana Carolina
Departamento de Ortopedia e Traumatologia, Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Dec 7;59(5):e696-e701. doi: 10.1055/s-0042-1757304. eCollection 2024 Oct.
To identify the causes of revision of total knee arthroplasty in a referral center in Brazil. This is a case series, with 80 patients undergoing revision surgery for total knee arthroplasty (RTKA) at a referral center for knee surgery, between August 2019 and November 2021, with a mean age of 69.6 years. Of these patients, 60.23% were female and 39.77% were male. The average body mass index (BMI) was 30.23 kg/m . The causes of TKA failure were defined as: periprosthetic infection according to the 2018 International Consensus Meeting criteria, ligament instability, range of motion limitation, periprosthetic fracture, malalignment, aseptic loosening, pain due to non-replacement of the patellar cartilage, polyethylene wear, fracture of implants, insufficiency of the extensor mechanism. Periprosthetic joint infection (PJI) was the main cause of revision total knee arthroplasty (TKA), corresponding to 47.73% of cases. Aseptic loosening of one or more components represented the second most frequent reason for TKA failure, accounting for 35.23% of revisions. Range of motion limitation represented the third most frequent cause, accounting for 5.68% of surgeries. Instability was the fourth most frequent reason for RTKA, occurring in 4.55% of patients. The other causes of revision were: periprosthetic fracture (3.41%), failure due to rupture of the extensor mechanism (2.27%), and pain attributed to non-replacement of the patellar cartilage (1.14%). Periprosthetic joint infection was the most frequent cause of TKA revision in our series. Other reasons for TKA failures were, in descending order: aseptic loosening, limited range of motion, and instability.
确定巴西一家转诊中心全膝关节置换术翻修的原因。 这是一个病例系列研究，2019年8月至2021年11月期间，80例患者在一家膝关节手术转诊中心接受了全膝关节置换翻修手术（RTKA），平均年龄为69.6岁。在这些患者中，60.23%为女性，39.77%为男性。平均体重指数（BMI）为30.23kg/m²。全膝关节置换失败的原因定义为：根据2018年国际共识会议标准的假体周围感染、韧带不稳定、活动范围受限、假体周围骨折、对线不良、无菌性松动、因未置换髌软骨导致的疼痛、聚乙烯磨损、植入物骨折、伸肌机制功能不全。 假体周围关节感染（PJI）是全膝关节置换翻修术（TKA）的主要原因，占病例的47.73%。一个或多个组件的无菌性松动是TKA失败的第二常见原因，占翻修手术的35.23%。活动范围受限是第三常见原因，占手术的5.68%。不稳定是RTKA的第四常见原因，发生在4.55%的患者中。其他翻修原因包括：假体周围骨折（3.41%）、伸肌机制断裂导致的失败（2.27%）以及因未置换髌软骨导致的疼痛（1.14%）。 假体周围关节感染是我们系列研究中TKA翻修最常见的原因。TKA失败的其他原因按降序排列为：无菌性松动、活动范围受限和不稳定。
