[骨科 关节资料]全膝关节置换术后为什么早期失败.pptxVIP

？全膝关节置换术后为什么早期失败 早期失败手术后3～5年 我们的病例1997.10～2005.10TKA术后1年内失败的病例感染 7例关节不稳定 2例髌股关节轨迹不良 3例早期松动 2例关节僵硬 2例 感 染 早期诊断至关重要初次手术术后病史伤口愈合不良、持续渗出持续低热静息痛局部体征红肿、皮温升高、局部波动感、窦道ESRCRP 关节不稳定术中伤及侧副韧带截骨不当（截骨不平衡或过量截骨）假体尺寸选择不当 术中伤及侧副韧带 截骨不当 髌股关节轨迹不良截骨不当假体植入位置不当假体尺寸选择失误软组织平衡不良 早期松动截骨不当假体位置植入不良假体尺寸选择失当骨水泥技术不良 术后僵硬关节内碎骨片、骨水泥残留疤痕形成软组织平衡不良假体尺寸不合适 Since 1991, 5760 knee arthroplasty procedures done by 53 surgeons have been registered in a community joint implant registry and were reviewed regarding initial revision done within the healthcare system. The 168 revisions done represented 2.9% of the knee arthroplasties between September 1991 and December 2002. Total knee arthroplasty is a predictable operation. Unfortunately, there is a subset of patients who do not do well and require revision surgery within the first 5 years. The purpose of the current study was to analyze the mechanisms of failure in patients who had revision surgery within 5 years of their index arthroplasty. Between 1986 and 1999, 440 patients with total knee arthroplasties were referred for revision surgery. An analysis of patients in whom the arthroplasties failed within 5 years of the index arthroplasty and the reasons for early failure were documented. A retrospective review was done on all patients who had revision total knee arthroplasty during a 3-year period (September 1997–October 2000) at one institution. Two hundred twelve surgeries were done on 203 patients (nine patients had bilateral surgeries). More than half of the revisions in this group of patients were done less than 2 years after the index operation. Fifty percent of early revision total knee arthroplasties in this series were related to instability, malalignment or malposition, and failure of fixation. TKA术后早期失败的主要原因感染不稳定髌股关节问题松动僵硬 恭祝马到成功