全膝关节置换术资料PPT课件.ppt

全膝关节置换术的治疗方案; 什么是骨性关节炎;病 理 特 点; 临 床 表 现;2 、关节僵硬 在早晨起床时关节僵硬及发紧感，也称之晨僵，活动后可缓解。关节僵硬在气压降低或空气湿度增加时加重，持续时间一般较短，常为几分钟至十几分钟，很少超过30分钟。;;5、关节无力、活动障碍 关节疼痛、活动度下降、肌肉萎缩、软组织挛缩可引起关节无力，行走时软腿或关节绞锁，不能完全伸直或活动障碍。 ;辅助检查;保缝尼远盲怪烘量既剩再爪仟缴揖第自礁樊闻辣氟咬窿宵吝柑仙鲍钙轿静全膝关节???换术全膝关节置换术;榆轻啦侗驶如昆费世甚彝酪霄甫章兵玄卜描勤泻傍窑褒遭汀烟角弗酉蜘菇全膝关节置换术全膝关节置换术;Work-up take long films of both lower limbs (standing, patellae facing forward, feet together) trace all previous X-rays and find the previous operation records (for revision cases) consider knee aspiration and bone (Indium111) scan if sepsis is suspected (for revision cases) 术 前 准 备 拍摄双侧下肢全长X光片 (站立位、髌骨向前、双足并拢) 回顾所有以前拍摄过的X光片并找出以往手术记录 (对于翻修病例) 如果怀疑感染﹐可考虑行膝关节穿刺和铟111同位素骨扫描 (对于翻修病例) ;Pre-operative (medical) fill in the total knee replacement arthroplasty documentation form confirm the presence of all prostheses and special instruments that may be needed with OT staff make sure that allograft is available if that is part of the surgical plan 术 前 准 备 ( 医 生 ) 填写全膝关节置换术记录表 与手术室同事确认所需的假体和特殊器械均已到位 手术方案中若需植骨﹐则事先确认有合适的异体骨可供选用 ;;Operative supine position, apply foot positioner before draping (so that the knee can be locked in full flexion) thigh tourniquet is applied but is only inflated after draping (tourniquet only used for cementation after 2001) no bulking drape around foot and ankle surgical approach (Insall) with periosteum elevated from medial third of the patella is adopted patella is replaced routinely in rheumatoid arthritis, but not osteoarthritis intramedullary guide for femoral cuts and extramedullary guide for tibial cuts cut surfaces are cleansed with pulsatile lavage system before cementation (no need for cementless fixation) all three components are inserted with one pack of Endurance cement mixed in partial vacuum; if exposure is sub-optimal, cement the patellar button and tibial tray first, and then insert the femoral component with another pack of cement (cement gun after 2001) tourniquet is deflated after all components are inserted and before wound