Dennis D A
Colorado School of Mines and the Rose Musculoskeletal Research Laboratory, Denver, USA.
Orthopedics. 1998 Sep;21(9):1036-8. doi: 10.3928/0147-7447-19980901-39.
Numerous options exist for management of minor bone defects associated with TKA. Biomechanical data demonstrate that filling defects with methylmethacrylate, with or without screw augmentation, results in inferior load transfer. Rectangular augmentations may be superior to angular wedges due to reduction in shear stresses. Controversy persists regarding superiority of use of bone graft versus augmentation. The author favors bone graft for cavitary defects, massive bone loss, and in younger patients in whom additional revision surgery is likely. Prosthetic augmentation is favored in peripheral defects of moderate size in more elderly patients.
对于全膝关节置换术（TKA）相关的小骨缺损，有多种处理方法。生物力学数据表明，用甲基丙烯酸甲酯填充缺损，无论有无螺钉增强，都会导致较差的负荷传递。由于剪切应力降低，矩形增强物可能优于角形楔块。关于使用骨移植与增强物哪种更具优势，仍存在争议。作者倾向于在有空洞性缺损、大量骨丢失的情况下以及可能需要进行额外翻修手术的年轻患者中使用骨移植。在年龄较大的患者中，对于中等大小的周边缺损，更倾向于使用假体增强物。
