Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee.
Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee.
复制标题
全膝关节置换术治疗皮质类固醇相关的膝关节缺血性坏死。
DOI：
10.1097/00003086-199705000-00019
复制
发表时间：
1997
影响因子：
4.2
通讯作者：
D. Hungerford
中科院分区：
文献类型：
--
作者：
M. Mont;T. H. Myers;K. Krackow;D. Hungerford
尽管年龄较大，但年龄小于50岁的患者因类固醇相关性缺血性坏死导致股骨髁塌陷，除了全膝关节置换术外，几乎没有其他选择。目前还没有全膝关节置换术治疗这种疾病的具体报告。1980年至1993年，对21例年龄小于50岁的股骨髁和胫骨平台缺血性坏死患者进行了31例多孔涂层解剖型全膝关节置换术。有17名女性和4名男性，平均年龄为36岁（范围，22-48岁）。21例患者中有17例患有系统性红斑狼疮，所有患者均有皮质类固醇使用史。患者在最终随访时接受了完整的临床和影像学评价，平均随访时间为8.2年（范围，2-16年）。总的来说，有17个良好和优秀的结果（55%）。11例膝关节因无菌性松动（37%）翻修，另外3例膝关节（10%）最终因深部脓毒症翻修。未诊断为系统性红斑狼疮的患者的6个膝关节均获得了良好的临床结果。25例系统性红斑狼疮患者中仅11例（44%）成功。当患者按类固醇使用程度、骨水泥固定与非骨水泥固定或活动水平分层时，结果无差异。
Despite their age, patients younger than 50 years who have collapse of their femoral condyles caused by steroid associated avascular necrosis have few options except total knee arthroplasty. There have been no specific reports of the results of total knee replacements for this disease. Between 1980 and 1993, 31 porous coated anatomic total knee replacements were performed in 21 patients younger than 50 years of age with avascular necrosis of the femoral condyles and tibial plateaus. There were 17 women and 4 men, with an average age of 36 years (range, 22-48 years). Seventeen of 21 patients had systemic lupus erythematosus, and all patients had a history of corticosteroid use. Patients underwent a complete clinical and radiographic evaluation at final followup that averaged 8.2 years (range, 2-16 years). Overall, there were 17 good and excellent results (55%). Eleven knees were revised for aseptic loosening (37%), and 3 additional knees (10%) ultimately were revised for deep sepsis. All 6 knees in patients with no diagnosis of systemic lupus erythematosus had excellent clinical results. There were only 11 of 25 successful outcomes (44%) in the patients with systemic lupus erythematosus. There were no differences in results when patients were stratified by degree of steroid use, cemented versus cementless fixation, or activity level.