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膝关节置换类型:多学科医疗团队的教育框架

Knee Arthroplasty Types: An Educational Framework for Multidisciplinary Healthcare Teams.

作者信息

Mahajan Uday, Akhtar Meraj, Sain Baijaeek, Sain Arnab

机构信息

Trauma and Orthopaedics, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.

Trauma and Orthopaedics, Lincoln County Hospital, Lincoln, GBR.

出版信息

Cureus. 2025 Jul 31;17(7):e89127. doi: 10.7759/cureus.89127. eCollection 2025 Jul.

Abstract

Knee arthroplasty is a widely performed surgical procedure that significantly improves the quality of life for patients with advanced knee joint diseases. However, many multidisciplinary healthcare professionals lack a clear understanding of the types and subtypes of knee arthroplasty, which is essential for effective perioperative care and rehabilitation planning. This narrative review categorises knee arthroplasty into three main types: total knee arthroplasty, partial knee arthroplasty, and revision knee arthroplasty. Total knee arthroplasty remains the most common procedure, with subtypes based on implant constraint, fixation method, bearing surface, alignment philosophy, surgical approach, and technological aids. Partial knee arthroplasty includes unicompartmental and patellofemoral replacements, offering faster recovery and more natural knee kinematics in appropriately selected patients, although with higher revision rates. Revision knee arthroplasty addresses failed implants using one-stage or two-stage procedures with specialised components such as constrained condylar and hinged implants, stem extensions, augments, and megaprostheses, but carries higher surgical complexity and complication risks. This educational framework aims to enhance multidisciplinary understanding of knee arthroplasty procedures, supporting better communication, patient education, and rehabilitation planning. Future research should validate its impact in educational settings and explore ongoing innovations in implant designs and surgical technologies to optimise patient outcomes.

摘要

膝关节置换术是一种广泛开展的外科手术,能显著提高晚期膝关节疾病患者的生活质量。然而,许多多学科医疗保健专业人员对膝关节置换术的类型和亚型缺乏清晰的认识,而这对于有效的围手术期护理和康复计划至关重要。本叙述性综述将膝关节置换术分为三种主要类型:全膝关节置换术、部分膝关节置换术和翻修膝关节置换术。全膝关节置换术仍然是最常见的手术,其亚型基于植入物的限制、固定方法、承重表面、对线理念、手术入路和技术辅助手段。部分膝关节置换术包括单髁置换和髌股关节置换,在适当选择的患者中能实现更快的恢复和更自然的膝关节运动学,尽管翻修率较高。翻修膝关节置换术使用一期或二期手术处理失败的植入物,采用特殊部件,如限制性髁和铰链式植入物、柄部延长件、增强物和大型假体,但手术复杂性和并发症风险更高。这个教育框架旨在增强多学科对膝关节置换术的理解,支持更好的沟通、患者教育和康复计划。未来的研究应验证其在教育环境中的影响,并探索植入物设计和手术技术的持续创新,以优化患者预后。

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