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患有布朗特病或类布朗特畸形患者的全膝关节置换术结果:一项系统评价

Outcome of total knee arthroplasty in patients with Blount disease or Blount-like deformity: a systematic review.

作者信息

Akkawi I, Zmerly H, Draghetti M, Felli L

机构信息

Orthopaedics and Traumatology Unit, Villa Erbosa Hospital, Via Dell'Arcoveggio 50/2, Bologna, Italy.

Department for Life Quality Studies, University of Bologna, Bologna, Italy.

出版信息

Musculoskelet Surg. 2025 Feb 22. doi: 10.1007/s12306-025-00893-x.

Abstract

Blount disease is a genetic disorder affecting the proximal tibial bone, resulting in a complex deformity of the knee. In the absence of timely treatment, the likelihood of developing degenerative arthritis increases. A total knee arthroplasty (TKA) is the conventional treatment for adult patients with Blount disease or Blount-like deformity with advanced degenerative changes. The aim of this systematic review is to evaluate the results of TKA in this particular cohort of patients. The present systematic review comprised a total of 5 articles. The 5 evaluated studies included data from 9 patients who undergone 12 TKAs. The patients were assessed throughout an average follow-up duration of 4 years. In all, there were three revisions of the prosthetic components. All studies achieved successful clinical scores at the last follow-up. A thorough exploration of PubMed, Embase, and Web of Science was conducted to identify research that documented the results of TKA in patients diagnosed with Blount disease or Blount-like deformity. TKA in patients with Blount disease or Blount-like deformities is intricate and demanding. Constrained implants can effectively mitigate the possible problem of persistent instability. Notwithstanding the unfavorable circumstances, TKA in this cohort of patients appears to yield satisfactory outcomes during the short- to medium-term period of observation. Other study is necessary to establish the enduring outcomes of TKA in this particular cohort of patients.

摘要

布朗特病是一种影响胫骨近端的遗传性疾病,会导致膝关节出现复杂畸形。若不及时治疗,发生退行性关节炎的可能性会增加。全膝关节置换术(TKA)是患有布朗特病或具有晚期退行性改变的布朗特样畸形的成年患者的常规治疗方法。本系统评价的目的是评估TKA在这一特定患者群体中的治疗效果。本系统评价共纳入5篇文章。这5项评估研究纳入了9例接受12次TKA手术患者的数据。患者的平均随访时间为4年。总共进行了3次假体组件翻修。所有研究在末次随访时均获得了成功的临床评分。通过全面检索PubMed、Embase和科学网,以确定记录TKA在诊断为布朗特病或布朗特样畸形患者中的治疗效果的研究。对患有布朗特病或布朗特样畸形的患者进行TKA手术复杂且要求高。限制性植入物可有效缓解可能出现的持续不稳定问题。尽管情况不利,但在这一患者群体中进行的TKA手术在短期至中期观察期内似乎能产生令人满意的结果。还需要其他研究来确定TKA在这一特定患者群体中的长期效果。

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