Bourne M H, Fox D L, Morrey B F
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905.
Clin Orthop Relat Res. 1993 Apr(289):170-4.
Hip arthroplasty with an ipsilateral knee arthrodesis occurs infrequently but does raise concern regarding surgical technical difficulties, dislocation, sepsis, and long-term loosening. Sixteen patients were evaluated 7.5 years (average period) after surgery. Technical difficulties were not prohibitive. No dislocation or revision was necessary in any of the cases. Two patients died as a result of unrelated sepsis from an infected knee. Loosening and protrusio of the acetabulum occurred in two patients. Hip arthroplasty in patients with a fused knee does not incur undue risk of loosening or instability and can provide long-term good function and pain relief. Patients with multiple joint arthroplasties, in whom concurrent sepsis occurs, can have devastating results.
同侧膝关节融合的髋关节置换术并不常见,但确实引发了对外科技术难度、脱位、感染和长期松动的担忧。对16例患者术后7.5年(平均时间)进行了评估。技术难度并非不可克服。所有病例均无需脱位或翻修。两名患者因感染性膝关节的无关感染败血症死亡。两名患者出现髋臼松动和突出。膝关节融合患者的髋关节置换术不会带来过度的松动或不稳定风险,并且可以提供长期良好的功能和疼痛缓解。发生并发败血症的多关节置换患者可能会有灾难性后果。