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全膝关节置换术后双侧髌骨缺血性坏死

Bilateral Patellar Avascular Necrosis Following Total Knee Arthroplasties.

作者信息

Page Glynnis K, Marina Jorge, Hoang Amy, Thompson Julia, Voss Lynn

机构信息

Orthopedics, Rocky Vista University College of Osteopathic Medicine, Parker, USA.

Orthopedic Surgery, BoulderCentre for Orthopedics and Spine, Boulder, USA.

出版信息

Cureus. 2025 Jan 2;17(1):e76798. doi: 10.7759/cureus.76798. eCollection 2025 Jan.

DOI:10.7759/cureus.76798
PMID:39897196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11786790/
Abstract

A 79-year-old female with a history of bilateral knee osteoarthritis presented with severe knee pain, eight years post-bilateral total knee arthroplasties (TKAs). Notably, a lateral retinacular release had been performed alongside each arthroplasty. On examination, she displayed new painful prominences along the lateral aspects of both knees. Radiographs and CT scans revealed near-complete resorption of the bilateral patellae, indicating advanced avascular necrosis (AVN). After discussing treatment options, the patient opted for revision surgery to remove the patellar hardware, leading to significant improvements in pain, function, and mobility. This case underscores the need for close, long-term follow-up in patients who undergo TKA with concurrent lateral retinacular release, to monitor for potential complications like AVN.

摘要

一名79岁有双侧膝关节骨关节炎病史的女性，在双侧全膝关节置换术（TKA）八年后出现严重膝关节疼痛。值得注意的是，每次关节置换术同时都进行了外侧支持带松解。检查时，她双侧膝关节外侧出现新的疼痛性隆起。X线片和CT扫描显示双侧髌骨几乎完全吸收，提示晚期缺血性坏死（AVN）。在讨论治疗方案后，患者选择翻修手术取出髌骨内固定物，术后疼痛、功能和活动能力得到显著改善。该病例强调了对接受TKA并同时进行外侧支持带松解的患者进行密切长期随访的必要性，以监测AVN等潜在并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/3467e96e2773/cureus-0017-00000076798-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/8f84df1c940c/cureus-0017-00000076798-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/973ae2978c09/cureus-0017-00000076798-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/859476c3a25d/cureus-0017-00000076798-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/f957a73b11f5/cureus-0017-00000076798-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/a926ae782bc6/cureus-0017-00000076798-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/7f8017ca2a7d/cureus-0017-00000076798-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/b057c2cb638d/cureus-0017-00000076798-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/3467e96e2773/cureus-0017-00000076798-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/8f84df1c940c/cureus-0017-00000076798-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/973ae2978c09/cureus-0017-00000076798-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/859476c3a25d/cureus-0017-00000076798-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/f957a73b11f5/cureus-0017-00000076798-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/a926ae782bc6/cureus-0017-00000076798-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/7f8017ca2a7d/cureus-0017-00000076798-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/b057c2cb638d/cureus-0017-00000076798-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760f/11786790/3467e96e2773/cureus-0017-00000076798-i08.jpg

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本文引用的文献

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Highlights of the 2021 American Joint Replacement Registry Annual Report.2021年美国关节置换登记处年度报告要点。
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