Ellingsen D E, Rand J A
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
J Bone Joint Surg Am. 1994 Jun;76(6):870-7. doi: 10.2106/00004623-199406000-00011.
Eighteen patients (eighteen knees) were managed with an intramedullary arthrodesis after a failed total knee arthroplasty. Twelve knees had had a revision total knee arthroplasty and six, a primary total knee arthroplasty. Three knees had had failure of a hinged prosthesis. In eleven knees, the arthroplasty had failed because of infection. Nine patients had had previous attempts at arthrodesis with external fixation. The average duration of the operation was six hours, and the average blood replacement was 2975 milliliters. A vascularized fibular pedicle graft was used in four patients. At a mean of thirty-seven months after the arthrodesis, sixteen of the eighteen patients had a complete radiographic union. The mean time to union was 5.5 months. Although a high rate of union was achieved in these patients, complications occurred in ten of the eighteen knees and this must be considered. Intramedullary arthrodesis is a successful method of salvage for a failed total knee arthroplasty or one complicated by infection that is not amenable to revision, but it is technically demanding and has frequent complications.
18例患者（18个膝关节）在全膝关节置换失败后接受了髓内关节融合术。其中12个膝关节曾接受过翻修全膝关节置换术，6个膝关节接受过初次全膝关节置换术。3个膝关节的铰链式假体出现故障。11个膝关节的置换术因感染而失败。9例患者曾尝试过外固定关节融合术。手术平均时长为6小时，平均输血量为2975毫升。4例患者使用了带血管蒂腓骨移植。关节融合术后平均37个月时，18例患者中有16例实现了影像学完全愈合。平均愈合时间为5.5个月。尽管这些患者的愈合率较高，但18个膝关节中有10个出现了并发症，对此必须加以考虑。髓内关节融合术是全膝关节置换失败或因感染而无法进行翻修的复杂病例的一种成功挽救方法，但该手术技术要求高，且并发症频发。
