Boettner Friedrich, El-Hassan Mohammed, Herold Johannes M
Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, 10021, New York, NY, USA.
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Österreich.
Orthopadie (Heidelb). 2025 Sep 3. doi: 10.1007/s00132-025-04714-8.
The treatment of patients following primary total knee arthroplasty requiring revision surgery is one of the most demanding tasks in orthopedic surgery. A careful failure analysis and a systematic approach are of great importance for the often very individual situations. In addition to excellent technical skills, preoperative planning is of great importance.
This paper describes the preoperative assessment and planning, as well as the technical strategy for the revision of primary knee arthroplasties.
Beside a review of the existing literature, the article introduces the senior author's revision strategies based on 20 years of experience in total joint replacement.
Adequate preoperative imaging, laboratory tests and, if necessary, joint aspiration are essential for the individual diagnostics and planning of the revision procedure. The article focuses on the prophylaxis and treatment options for acute and chronic periprosthetic joint infections, aseptic implant loosening, arthrofibrosis and joint instability.
It is often a challenge for the surgeon to face his/her own patient requiring a revision surgery, and the patient expects the same result for these technical, often much more demanding operations as for the primary surgery. This inherent conflict results in considerable challenges for the arthroplasty surgeon.
初次全膝关节置换术后需要翻修手术的患者治疗是骨科手术中要求最高的任务之一。对于通常非常个体化的情况，仔细的失败分析和系统的方法至关重要。除了精湛的技术技能外，术前规划也非常重要。
本文描述了初次膝关节置换翻修的术前评估与规划以及技术策略。
除了回顾现有文献外，本文还介绍了资深作者基于20年全关节置换经验的翻修策略。
充分的术前影像学检查、实验室检查以及必要时的关节穿刺对于翻修手术的个体化诊断和规划至关重要。本文重点关注急性和慢性假体周围关节感染、无菌性植入物松动、关节纤维化和关节不稳的预防及治疗选择。
外科医生面对自己需要翻修手术的患者往往是一项挑战，而且患者期望这些技术上通常要求更高的手术能取得与初次手术相同的效果。这种内在冲突给关节置换外科医生带来了相当大的挑战。
