Zambelli P Y, Leyvraz P P, Wellensiek B
Hôpital Orthopédique de la Suisse Romande, Lausanne.
Ther Umsch. 1996 Oct;53(10):797-805.
The story of the total knee arthroplasty begins in the last century. But in 1971, Gunston shows the way of the modern knee arthroplasty and creates the concept of unconstrained arthroplasty. The indication of the total knee arthroplasty should be precise and rigorous. It's not possible to describe all the situations, where a total knee arthroplasty is indicated or not, but the clinical signs could be summarized in pain, stiffness, deformation with or without instability. We observed 10% of postoperative complications; most of them are secondary, but the infections and loosening remain the principal problem in 2% and in 5% of cases, respectively. If the results are now quite the same to those of total hip arthroscopy by survivorship analysis, the indication and the choice of the total knee prosthesis should be passed on a reflection, where the clinical and functional evaluation are the most important.
全膝关节置换术的历史始于上世纪。但在1971年，冈斯顿展示了现代膝关节置换术的方法，并创造了非限制性关节置换术的概念。全膝关节置换术的适应症应精确且严格。不可能描述所有全膝关节置换术适用或不适用的情况，但临床症状可归纳为疼痛、僵硬、伴有或不伴有不稳定的畸形。我们观察到术后并发症发生率为10%；其中大多数是继发性的，但感染和松动分别在2%和5%的病例中仍然是主要问题。如果通过生存率分析，目前全膝关节置换术的结果与全髋关节置换术的结果相当，那么全膝关节假体的适应症和选择应该基于一种思考，其中临床和功能评估是最重要的。
