Kohn D, Schmolke S
Orthopädische Klinik, Klinik II im Annastift e. V., Medizinische Hochschule Hannover.
Orthopade. 1996 Apr;25(2):153-7.
Two percent of primary and 8% of revision total knee replacements are followed by arthrodesis. Today knee arthrodesis is the most important salvage procedure after failed total knee arthroplasty, resection arthroplasty and above-the-knee amputation being the only alternatives. Analysis of the literature between 1984 and 1994 revealed 533 cases treated with arthrodesis of the knee; 403 were done after failed total knee arthroplasty. The fusion rate was 74%. External fixation, intramedullary nail, plates and combinations of these are currently used for fixation. The literature and an analysis of our own patients from 1988 to 1994 showed that arthrodesis after failed arthroplasty is a difficult procedure, and complications often occur. Bone loss of the distal femur and proximal tibia is the one most important prognostic factor. A new classification system for bone loss is presented.
初次全膝关节置换术后有2%、翻修全膝关节置换术后有8%的患者最终接受了膝关节融合术。如今，膝关节融合术是全膝关节置换失败后最重要的挽救手术，仅有的替代方案是关节切除成形术和膝上截肢术。对1984年至1994年间的文献分析显示，有533例患者接受了膝关节融合术治疗；其中403例是在全膝关节置换失败后进行的。融合率为74%。目前用于固定的方法有外固定、髓内钉、钢板以及这些方法的联合应用。文献及对我们自己1988年至1994年患者的分析表明，置换失败后的关节融合术是一项困难的手术，且并发症常常发生。股骨远端和胫骨近端的骨丢失是最重要的预后因素。本文提出了一种新的骨丢失分类系统。
