全肘关节置换术后翻修治疗的研究进展

Research progress in revision surgery after total elbow arthroplasty

全肘关节置换术(TEA)是治疗终末期肘关节炎的有效外科手段,但与髋、膝关节置换术相比,其假体存活率仍较低而术后并发症发生率更高。翻修的主要原因包括无菌性松动、假体周围感染、假体周围骨折、假体组件失效和术后不稳定,其中最常见原因是无菌性松动。与初次TEA不同,翻修手术通常需处理感染、瘢痕、大块骨缺损、假体柄拔出、骨水泥清除等复杂情况,手术难度更大。目前,我国对TEA翻修的相关研究较少。因此,笔者从术后翻修原因、翻修术中关键问题处理和治疗结局三个方面进行综述,为TEA后翻修术的临床应用和研究提供参考。

Total elbow arthroplasty(TEA)is an effective surgical method for treatment of end-stage elbow arthritis.However,compared with hip and knee arthroplasties,the implant survival rate of TEA remains low,with a high postoperative complications rate and a high revision rate.The main reasons for revision include aseptic loosening,periprosthetic infection,periprosthetic fracture,component failure,and postoperative instability,of which the most common cause is aseptic loosening.Unlike the initial TEA,revision surgery usually needs to deal with complicated conditions such as infection,scars,bone defects,prosthetic stem extraction and cement removal,making the operation more difficult.There are few clinical studies related to TEA revision in China.Therefore,the authors review the reasons for postoperative revision,the management of key intraoperative issues,and the outcomes of treatment to provide the basis for future clinical application and academic research of TEA revision surgery in China.