全膝关节置换术后伸膝装置破坏的研究进展

Research progress of knee extensor mechanism destruction after total knee arthroplasty

伸膝装置破坏是全膝关节置换术(TKA)后的严重并发症,发生率为1%~10%。它常以可观测到的慢性多因素病理变化为准,以髌韧带作为主要的破坏位置。治疗伸膝装置破坏的主要方式是使用同种异体或合成移植伸膝装置。文献报道这些技术相对于其他治疗方法并无优越性,虽然这种选择对于患者是量身定制的。同种异体移植伸膝装置可以更好地恢复解剖结构,而且合成网技术和直接修复不能超时拉长。同种异体修复相对于合成修复增加了感染风险,合成网技术更加便宜而且更容易完成。本文重点综述了TKA后伸膝装置慢性破坏的病变机制的病因、以便诊断及治疗。

Knee extensor mechanism destruction is a serious complication after total knee arthroplasty(TKA).The incidence is 1%-10%.It is commonly observed as a chronic multifactorial pathology changes with the patellar tendon as the most common site of rupture.Knee extensor mechanism reconstruction can be performed using allogenic or synthetic grafts.The literature reports that these techniques are not superior to other therapies,although this choice is tailored for patients.Allograft knee extension device can restore anatomical structure better,and synthetic mesh technology and direct repair can not be extended over time.Allograft repair increases the risk of infection compared with synthetic repair,and synthetic mesh technology is cheaper and easier to complete.This review focuses on the etiology,diagnosis and treatment of chronic destruction of knee extensor device after TKA.