[单室膝关节置换术失败后的翻修可能性——116例翻修分析]。

M Tinius, S Klima, B Marquass, W Tinius, C Josten
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引用次数: 9

摘要

目的:单室膝关节置换术(UKA)的一个主要优点是快速康复,小的组织创伤和大多数简单的翻修全膝关节置换术。该研究的目的是检查是否总是有必要转换为全内假体,因为目前在雪橇系统缺陷的情况下经常被推荐,或者在某些条件下使用单髁系统进行翻修是否有很好的成功机会。方法:对116例单室膝关节置换术后首次出现问题和随访45个月(范围:10-86个月)期间的修复进行研究,使用膝关节社会评分并分析各种附加手术以及前交叉韧带替代,斜度矫正等。包括更换假体或改为全关节置换术的翻修。结果:60.3%的病例可以在单室膝关节系统内进行翻修,平均评分为167.4(范围:144-173)。结果得分与文献中首次UKA植入的结果和转换手术到全假体的结果一致(p < 0.05 Wilcoxon检验)。结论:在低病例数的批判性思考和这种短期到中期的检查下,个别的修正方案似乎在单髁系统中有其权利,也有对TKA的转换操作。在进一步判断之前,绝对需要长期的结果和更大的病例数。
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[Revision possibilities after failed unicompartmental knee arthroplasty--an analysis of 116 revisions].

Aim: A major advantage of the unicompartmental knee arthroplasty (UKA) is the quick rehabilitation, small traumatisation of tissue and the mostly uncomplicated revision to a total knee arthroplasty. The aim of the study is to examine whether the conversion to the total endoprosthesis, as is frequently is recommended at present in cases of defect of the sleigh system, is always necessary or whether a revision can have good chances of success with use of the unicondylar system under certain conditions.

Method: 116 revisions were studied after unicompartmental knee arthroplasty at the first appearance of problems and during the follow-up of 45 months (range: 10-86 months) using the Knee Society Score and analyses of the various additional procedures as well as the anterior cruciate ligament substitute, the correction of slope etc. Revisions, with exchange of components or a conversion to a total arthroplasty, were included.

Results: In 60.3 % of all cases a revision could be performed within the unicompartmental knee system, with a mean score of 167.4 (range: 144-173). The outcome score corresponded to the outcome of primary UKA implantations and to conversion operations to total endoprosthesis in the literature (p < 0.05 Wilcoxon test).

Conclusion: Under critical contemplation of the low case number and this short- to medium-term examination, individual revision solutions seem to have their entitlement within the unicondylar system as also do conversion operations to the TKA. Long-term results and larger case numbers are absolutely necessary prior to further judgment.

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