膝单髁置换术后不明原因疼痛的研究进展

Advances in the diagnosis and treatment for unexplained pain after unicompartmental knee arthroplasty

疼痛是膝单髁置换术(UKA)的主要手术适应证,缓解疼痛既是手术治疗的目标,也是评价手术是否成功的主要标准。判断UKA术后疼痛原因时,更多关注的是假体对位对线不良、感染、假体松动、假体周围骨折等手术相关因素,对不明原因疼痛的认识不足。UKA术后不明原因疼痛多位于胫骨前内侧,由于引起疼痛的原因比较隐匿,常规检查方法不易察觉。UKA术后不明原因疼痛的发生率远高于全膝关节置换术,对其进行翻修的手术技术要求相对较低,常进行了不必要的翻修。本文对UKA术后不明原因疼痛的原因及诊治措施进行综述,阐述目前学术界对该并发症的认识。

For patients with isolated anteromedial knee osteoarthritis,pain and its impact on activity of daily living is the main indication for unicompartmental knee arthroplasty(UKA).Consequently,pain relief after surgery is an important criterion of successful UKA.When surgeons judged the cause of postoperative pain,they paid more attention to surgery-related factors such as malalignment,infection,aseptic loosening,and bone fracture,and had no sufficient understanding of unexplained pain.Unexplained pain often occurs in the anteromedial tibia after UKA,and are not easy to be detected conventional examinations.The incidence of unexplained pain after UKA is much higher than that after total knee arthroplasty.The technical requirements for revision surgery are relatively low,and unnecessary revisions are often performed in patients with unexplained pain.The aim of this review is to evaluate current evidence regarding incidence,risk factors,diagnostic method,and treatment options of unexplained pain in UKA.