Laporte C, Laude F, Rolland E, Saillant G
Service de Chirurgie Orthopédique et Traumatologique, C.H.U. Pitié-Salpêtrière, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1997;83(4):378-81.
Femoral component dislocation in unicondylar knee arthroplasty is rare. One case is reported.
A 59 years old man required revision of his unicondylar knee arthroplasty for loosening and dislocation of the femoral component 3 years after its insertion. Revision was performed and we found a technical error: distal and posterior femoral cut was too thin, and with components in place, there was a tendancy for the components to "rock" as the knee was flexed. The implants were too tight in flexion. A new unicondylar knee arthroplasty was performed.
The posterior condylar bone resection should reach at least the thickness of the metal implant. It is better to resect slightly too much of the posterior condyle than too little in order to avoid tightening of the knee in flexion. The femoral component must accurately reproduces the anterior-posterior dimension of the femoral condyle.
With better selection of patients and surgeons who are more familiar to this type of procedure loosening and dislocation of an unicondylar knee arthroplasty should be avoided.
单髁膝关节置换术中股骨部件脱位较为罕见。本文报告一例。
一名59岁男性在单髁膝关节置换术后3年,因股骨部件松动和脱位需要进行翻修手术。手术中发现技术失误:股骨远端和后侧截骨过薄,当膝关节屈曲时,假体就位后有“晃动”倾向。假体在屈曲时过紧。遂进行了新的单髁膝关节置换手术。
后髁骨切除应至少达到金属假体的厚度。为避免膝关节屈曲时过紧,后髁切除宁多勿少。股骨部件必须准确再现股骨髁的前后尺寸。
通过更好地选择患者以及由更熟悉此类手术的外科医生进行操作,应可避免单髁膝关节置换术出现松动和脱位。