可移动全膝关节置换术后外伤性胫股前脱位2例

Q4 Medicine

Trauma Case Reports Pub Date : 2025-02-17 DOI:10.1016/j.tcr.2025.101144

Carlijn Schoutens , Peter A. Nolte , Arthur van Noort

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引用次数: 0

摘要

背景：胫股前脱位是全膝关节置换术后的严重并发症。它是罕见的，与轴承旋出明显不同。大多数胫股脱位发生在后侧。以前在各种假体设计中描述过前位脱位，但在可移动的假体中没有。我们提出了两个病例，并为这种罕见和严重的损伤的处理提供了建议。病例描述：71岁和73岁女性患者首次植入可移动全膝关节置换术后15年和8年，发生2例完全性胫股前脱位。1例经闭合复位后完全恢复。在另一例患者中，闭合复位失败，进行了切开复位，在患者最初恢复后，由于不稳定需要进行翻修手术。无神经血管并发症。随访时间分别为23个月和14个月。结论胫股前脱位是一种严重的损伤，有并发并发症的危险。所有病例的早期处理应包括迅速复位、连续神经血管检查和CT血管造影。晚期治疗应包括关节稳定性评估。

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Traumatic anterior tibiofemoral dislocation of mobile-bearing total knee arthroplasty: Two cases

Background

Anterior tibiofemoral dislocation is a severe complication of a total knee arthroplasty. It is rare, and it is distinctly different from bearing spinout. Most tibiofemoral dislocations are posterior. Anterior dislocation has previously been described in various prosthesis designs, but not in mobile-bearing prostheses. We present two cases and provide recommendations for the management of this rare and severe injury.

Case description

Two cases of complete anterior tibiofemoral dislocation were brought on by trauma, fifteen and eight years after initial implantation of mobile-bearing total knee arthroplasties in 71-year-old and 73-year-old female patients. One was managed with closed reduction and made a full recovery. In the other, closed reduction failed, open reduction was performed, and there was a need for revision surgery for instability after her initial recovery. There were no neurovascular complications. Follow-up was 23 and 14 months respectively.

Conclusion

Anterior tibiofemoral dislocation is a severe injury with a risk of concomitant complications. Early management should include prompt reduction, serial neurovascular exams and CT angiography for all cases. Late management should include assessment of joint stability.

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.