人工关节置换术相关并发症的防治探讨

To probe into-the prevention and cure of related complications in total knee arthroplasty

对于髋关节与膝关节非感染性的晚期病变来说，人工关节置换已成为清除病灶，缓解疼痛和保留改善关节功能的最佳选择。《中国骨与关节杂志》本期围绕人工髋关节与膝关节置换术之主题刊登了数篇文章。这些文章从不同的角度探讨了目前关节外科医生最为关注的热点和焦点，非常值得阅读和讨论。

For patients and surgeons, infection in total knee arthroplasty （ TKA ） is a catastrophic complication. The main symptoms of infection after TKA are pain and function limitation. The most common clinical manifestations include severe pain and claudication. Only with active dehridement and eradication of the focus of infection, infection can be completely controlled, and the joint function can be preserved to the greatest extent. Inflammatory lesions cannot be cleared by simple irrigation through a tube or local application of antibiotics. With thorough debridement and irrigation, the joint is opened, into which absorbable gelatin sponge is filled after immersed in gentamicin, in order to achieve the treatment goal of sustained release of antibiotics. Deep vein thrombosis （ DVT ） of the lower extremity is one of the most common complications after TKA, which is also the primary cause of pulmonary embolism or even sudden death. Early detection and definitive diagnosis are the key points in the prevention and cure of DVT of the lower extremities. Before TKA, it is mostly concerned by surgeons how to complete the surgical procedure safely and smoothly, and to prevent surgical complications. Pain, walking distance and joint range of motion are also focused in the postoperative evaluation. It is concerned by patients and their relatives whether they could walk without difficulties, they could live by themselves in their daily lives and the surgery will success or not, and the serving life of joint prostheses. The concerns of the patients are basically the same as the surgeons do. What differs is only the means of expression. Before the surgery, it is advised to better communicate with the patients and fully realize what they need, which could make them feel less nervous preoperatively, and fully cooperate with the surgeons during the fimctional recovery period.