全膝关节置换术后关节不稳

Instability following total knee arthroplasty

人工全膝关节置换术(TKA)是目前治疗膝关节骨关节炎、膝关节类风湿性关节炎等膝关节疾病的主要术式,在减轻病变关节疼痛、改善关节功能方面具有良好的效果。TKA的目标就是恢复正常膝关节的功能和稳定,但在接受TKA的患者中,有高达20%的患者对术后效果不满意,关节不稳是引起患者术后不满意的主要原因之一。探讨关节不稳有利于改进产品的设计制造理念、提高产品性能,同时可以帮助手术医生优化手术技术、减小人为因素导致的关节不稳。影响关节不稳的因素众多,假体的影响(如假体设计、假体选择)、手术技术(如截骨误差、关节线水平)和患者因素(如年龄、性别、体重)等都对膝关节置换术后稳定性产生重要影响。关节不稳是膝关节翻修的一个常见指征,大多数保守治疗无效,因此应通过优化假体设计、提高手术技术、指导患者康复等方法进行预防,必要时行翻修手术。

Total knee arthroplasty(TKA)is currenly the main surgical method for the treatment of knee ostearhitis,rheumatoid arthritis and other knee diseases.It has a good efect in reducing the pain of diseased joints and improving joint function.The goal of TKA is to restore normal knee function and stability.However,among patients rceiving TKA,up to 20%of patients are issatisfied with the postoperative efect,and joint instability is one of the main causes of pastoperative dstisfaction.Discussing joint instability is helpful to improve product design and manufacturing concepts and improve produet performance.At the same time,it can help surgeons optimize surgical techniques and reduce joint instability caused by human factors.There are many factors that affect joint instability.The impact of prosthssis(such as prosthesis design,prosthesis selection),surgical technique(such as osteotomy error,joint line level)and patient factors(such as age,gender,weight),ete.The stability after joint replacement has an important impact.Joint instability is a common indication for knee revision,and most conservative treatments are ineffective.Therefore,it should be prevented by optimi zing the design of the prosthesis,improving the surgical technique,and guiding the rehabilitation of the patient.