膝关节置换患者手术失败原因的分析
Causes of failure after total knee arthroplasty
目的 分析膝关节置换术(TKA)后失败的原因.方法 回顾性分析2007年1月至2013年12月解放军总医院骨科膝关节置换术失败患者完整手术资料181例.结果 膝关节初次置换的各种失败原因依次为感染53%(96/181),松动16%(29/181),膝关节僵直粘连10%(18/181),不稳6.6%(12/181),伸膝装置问题5%(9/181),衬垫磨损4.4%(8/181),假体周围骨折2.8%(5/181),其他2.2% (4/181).64.1%的TKA失败发生在前2年,19.9%的TKA失败发生在2 ~5年,16.0%的TKA失败发生在5年以后,高达84.0%的失败病例发生在5年内.结论 初次膝关节置换失败的前3位原因分别是感染、无菌性松动和膝关节僵直粘连.
更多Objective To identify the causes of failure after total knee arthroplasty (TKA).Methods Retrospective reviews were conducted for the causes of failures of 181 TKA patients between January 2007 and December 2013.Results Among the causes of failures after primary TKA,infection was the major cause of failure (53%,96/181) followed by aseptic loosening (16%,29/181),arthrofibrosis (10%,18/181),instability (6.6%,12/181),extensor mechanism problem (5%,9/181),wear (4.4%,8/181),periprosthetic fracture (2.8%,5/181) and others (2.2%,4/181).And 64.1% occurred in the first two years,19.9% occurred between 2 and 5 years and 16.0% occurred after 5 years after operation.Up to 84.0% occurred in 5 years.Conclusion The top three causes of failures after primary TKA at our center are infection,aseptic loosening and arthrofibrosis.
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