一期全膝关节置换术加改良全稳定假体治疗66岁继发膝骨关节炎和外翻畸形患者。病例报告

Mihai Gherman, A. Sere, Mihai-Daniel Angheluță, R. Coste
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引用次数: 1

摘要

膝关节骨性关节炎(gonarthrosis)是当今第三年龄人群中最常见的膝关节病理,导致严重的残疾和生活质量下降。继发性膝关节病可能是由创伤性事件引起的,创伤性事件使膝关节承受短暂的高度增加的机械应力,启动关节软骨和邻近骨组织的快速进行性退化过程。TKA的目的是用人工部件代替关节内的所有构件,以减轻疼痛,补偿韧带不稳定,纠正畸形,恢复关节的正常功能。半约束、非铰接植入物通常用于已经有原发性TKA但持续并发症的膝关节翻修TKA。然而,我们报告了一例66岁的女性患者,诊断为创伤后关节病,由于严重的关节不稳定和高度的外翻偏差,她接受了TKA和改良的全稳定植入物作为主要治疗。手术的结果是积极的,疼痛明显缓解,膝关节稳定性增加。外翻角由37°减少到4°,KSS评分由3分增加到87分。因此,在严重的病例中,翻修半约束假体可作为首选种植体,效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary Total Knee Arthroplasty (TKA) with revision Total Stabilizer Prosthesis in a 66-year-old patient with secondary knee osteoarthritis and valgus deformity. Case Report
Abstract Knee osteoarthritis (gonarthrosis) is the most prevalent knee pathology encountered nowadays in the third age population, leading to severe disability and reduced life quality. Secondary gonarthrosis may be caused by a traumatic event, which subjects the knee joint to a transitory highly increased mechanical stress, initiating a rapidly progressive degrading process of the articular cartilage and subjacent bone tissue. TKA is intended to replace all the intra-articular components with artificial parts, in order to relieve pain, compensate for ligament instability, correct deformities, and restore proper joint functionality. Semi-constrained, non-hinged implants are usually used for revision TKA, in knees that already had a primary TKA but sustained complications. Nevertheless, here we reported the case of a 66-year-old female patient diagnosed with posttraumatic gonarthrosis who underwent TKA with a revision total stabilizer implant as primary treatment due to severe joint instability and high grade valgus deviation. The outcome of the surgical procedure was positive, with significant pain relief and increased knee stability. The valgus angle was reduced from 37° to 4° and the KSS score increased from 3 to 87 points. Therefore, revision semi-constrained prosthesis may be used as a primary implant with promising result in severe cases.
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