膝关节创伤后骨关节炎的治疗现状

Treatment Status of Osteoarthritis After Knee Trauma

膝关节创伤后骨关节炎(PTOA)是关节内和关节外骨折后的常见并发症。此外,PTOA也可能是孤立的软骨缺损、半月板切除和韧带损伤的结果。膝关节骨折的治疗方法多种多样。然而,当PTOA非手术治疗失败时,假体内关节置换是首选方法。初次全膝关节置换术(TKR)用于治疗膝关节骨折只适用于部分负重或非负重无法活动的老年患者、严重骨质破坏者、有症状的老年人骨关节炎(OA)患者,而且它通常与主要使用模块化植入物有关。另外,PTOA行全膝关节置换术的并发症发生率较高。胫骨平台骨折后伸肌机构的问题很常见。也有一些问题是由先前存在的疤痕、骨不连(感染引发)、排列不齐、活动受限或不稳定引起的。

Post-traumatic osteoarthritis of knees(PTOA)is one of common complications after intra-articular and extra-articular fractures.In addition,PTOA may be result of isolated cartilage defect,meniscectomy and ligament injury.Treatment methods of knee joint fracture are various.However,when non-surgical treatment of PTOA fails,prosthetic joint replacement is the preferred method.Initial total knee replacement(TKR)is only applicable to elderly knee fracture patients with partial or nonweight-bearing moving inability,serious bone destructors,and symptomatic elderly patients with osteoarthritis(OA).Moreover,it is usually related to main use of modular implants.In addition,total knee arthroplasty can achieve high complications incidence for PTOA.There are common problems of extensor mechanism after tibial plateau fracture,which may be caused by pre-existing scars,bone nonunion(caused by infection),irregular alignment,limited mobility or instability.