优化活动平台单髁术后衬垫脱位的预防与治疗策略

Prevention and treatment of bearing dislocation of mobile-bearing unicompartmental knee arthroplasty

衬垫脱位是活动平台单髁置换的特有并发症,其发生原因包括屈伸间隙平衡不佳、假体安放位置偏差、残留骨赘或骨水泥撞击、内侧副韧带松弛或损伤、外伤及患者长期做高屈曲动作等,大部分脱位由多因素造成。术前严格把握单髁置换适应证,术中准确地截骨、安放假体同时保护内侧副韧带,术后制定适宜的康复动作及活动强度,可减少衬垫脱位的发生。衬垫脱位的治疗应根据其原因及患者个体情况选择个性化的治疗方案。

Bearing dislocation is a special complication of mobile-bearing unicompartmental arthroplasty,caused by many factors,such as imbalance of the flexion and extension gap,malposition of components,impingement by the remaining osteophytes and cement,damage or delayed chronic laxity of medial collateral ligament,traumatic accident and habitual high knee flexion.It can be reduced by strictly controlling the operation indications before operation,osteotomy and implanting the prosthesis accurately while protecting the medial collateral ligament during operation,actively guiding the appropriate rehabilitation actions and activity intensity of patients after operation.Treatment should be individualized according to the causes and individual conditions of patients.