严重的膝关节冠状面畸形初次膝关节置换应对策略

The strategy of primary total knee arthroplasty for severe coronal plane deformities

人工全膝关节置换术疗效确切，可以达到缓解疼痛、改善功能、提高生活质量的目的。膝关节置换术在治疗膝关节终末期病变中，术后15～23年留存率91%～95%。恢复正常下肢力线、良好的假体位置、熟练的软组织平衡技术以及获得适当的髌骨运动轨迹，是膝关节置换手术的4要素[1-5]。在初次膝关节置换手术中，如果能把握以上4个要素，可以获得确切的、良好的术后效果。

Based on certain conclusive evidence, total knee arthroplasty （ TKA ） has shown excellent results in the treatment of end-stage knee joint disorders. With the development and popularization of knee replacement technology and the enlarging indications of primary TKA surgery, the number and dififculty of complex primary TKA has shown a rapid rise. Due to the scarcity of complex primary TKA cases, some orthopaedic surgeons don’t have enough direct experience on complex primary TKA, which has become an important cause for the lack of good clinical results after complex primary TKA. In this paper, knowledge and literature about complex primary TKA for severe coronal plane deformities are summarized and analyzed, which will be helpful to the clinical work.