Peterson L F, Fitzgerald R H, Johnson E W
Mayo Clin Proc. 1979 Sep;54(9):564-9.
Total knee replacement has become an established form of treatment for gonarthrosis and usually results in excellent relief of pain and approximately 90 degrees of joint motion with satisfactory joint stability. The anatomic stability that cannot be restored at surgery must be provided for by additional prosthetic stability. Fixation of prosthetic devices, particularly in the tibia, is marginal and results in an increased incidence of loosening when the quality of bone is weak, as in osteoporosis, or when shear stress is increased because of malalignment or prosthetic constraint. Resurfacing techniques provide the greatest options if surgical revision is necessary. Surgical goals should be realistically assessed so as to maintain the best potential for future treatment options.
全膝关节置换术已成为治疗膝关节病的一种成熟治疗方式，通常能显著缓解疼痛，使关节活动度达到约90度，关节稳定性令人满意。手术中无法恢复的解剖稳定性必须通过额外的假体稳定性来提供。假体装置的固定，尤其是在胫骨部位，效果有限，当骨质质量较差（如骨质疏松症）或因对线不良或假体限制导致剪切力增加时，松动发生率会升高。如果需要进行手术翻修，表面置换技术提供了更多选择。应切实评估手术目标，以便为未来的治疗选择保留最佳潜力。
