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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 267 -275. doi: 10.3877/cma.j.issn.1674-134X.2023.02.017

综述

膝关节内侧单髁置换术后并发症的诊治进展
谭红略†(), 于进洋, 史小涛, 王啸, 袁彦浩   
  1. 471002　河南省洛阳正骨医院（河南省骨科医院）
  • 收稿日期:2022-06-10 出版日期:2023-04-01
  • 通信作者: 谭红略

Diagnosis and treatment of complications after medial unicompartmental knee arthroplasty

Honglue Tan†(), Jinyang Yu, Xiaotao Shi, Xiao Wang, Yanhao Yuan   

  1. Center of Knee Joint Surgery, Henan Luoyang Orthopedic-Traumatological Hospital (Henan Orthopedic Hospital), Luoyang 471002, China
  • Received:2022-06-10 Published:2023-04-01
  • Corresponding author: Honglue Tan
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谭红略, 于进洋, 史小涛, 王啸, 袁彦浩. 膝关节内侧单髁置换术后并发症的诊治进展[J/OL]. 中华关节外科杂志(电子版), 2023, 17(02): 267-275.

Honglue Tan, Jinyang Yu, Xiaotao Shi, Xiao Wang, Yanhao Yuan. Diagnosis and treatment of complications after medial unicompartmental knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(02): 267-275.

单间室膝关节置换术(UKA)是治疗老年终末期膝关节骨关节炎(OA)的有效外科手段，并已取得了良好的长期临床随访效果。与全膝关节置换术(TKA)一样，UKA术后也存在因并发症而影响疗效的问题；而且一旦发生某些并发症，其治疗一样具有挑战性。本综述通过文献的回顾分析，探讨UKA术后并发症的临床诊治现状及导致并发症的危险因素及规避措施等，进而提高UKA术后患者的临床疗效。结果显示，相对于TKA，UKA术后并发症发生率较低，包括假体无菌性松动、外侧间室OA进展、不明原因疼痛、聚乙烯衬垫磨损、衬垫脱位、假体周围感染、假体周围骨折、下肢深静脉血栓(DVT)、骨水泥残留脱落、金属超敏反应及金属沉着病等。导致并发症的原因主要为手术适应证选择不当、手术操作不规范及围手术期管理不足所致。基于这些原因，规避术后并发症发生的有效措施为选择合适的患者、掌握规范的手术原则及标准化手术技术、关注围手术期管理等。对于治疗，将根据不同并发症的不同原因及类型，个体化选择保守或手术治疗等。

关键词: 膝, 骨关节炎, 关节成形术，置换，膝, 诊断, 治疗学

Unicompartmental knee arthroplasty(UKA) is an effective surgical treatment for the endstage osteoarthritis of knee, and with good long-term clinical results. However similar to total knee arthroplasty (TKA), there still exist postoperative complications that affect the clinical outcomes of UKA. Once complications occur, the treatment is challenging for orthopedic surgeons. Through retrospective analysis of the literatures, this review discussed the clinical diagnosis and treatment of complications during and after medial UKA and analyzed the risk factors that lead to the complications and the methods to prevent the complications, hence to improve the clinical efficacy of UKA. Results of the analyses have shown that the incidence of complications after UKA is lower in comparison with TKA. The perioperative complications of UKA include aseptic loosening of prosthesis, progression of arthritis in lateral compartment, unexplained pain, wear of polyethylene, mobile-bearing dislocation, periprosthetic joint infection (PJI), periprosthetic fracture, deep venous thrombosis (DVT), bone cement residue and metal allergy, etc. The main causes for complications are improper surgical indications, poor surgical technique and inadequate perioperative management. Based on these factors, effective measures to avoid postoperative complications should be taken to select suitable patients, master standardised surgical techniques and procedures, and pay more attention to perioperative management. For treatment of complications, conservative or surgical treatment should be applied individually according to types and causes of the complications.

Key words: Knee, Osteoarthritis, Arthroplasty, replacement, knee, Diagnosis, Therapeutics
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