Current etiologies and modes of failure in total knee arthroplasty revision
Current etiologies and modes of failure in total knee arthroplasty revision
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DOI：
10.1097/01.blo.0000214421.21712.62
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发表时间：
2006-05-01
影响因子：
4.2
通讯作者：
Saleh, Khaled J.
中科院分区：
文献类型：
--
作者：
Mulhall, Kevin J.;Ghomrawi, Hassan M.;Saleh, Khaled J.
虽然全膝关节置换术是一种非常有效的干预措施，并且其流行率不断增加，但失败仍有发生。我们研究了行全膝关节置换术翻修的患者，以确定短期和长期失败的任何可改变的原因，以及未来应努力减少失败发生率的方向。一项多中心前瞻性观察性队列研究，对318例连续患者进行了全膝关节置换翻修术，至少随访1年。还评估了失效模式之间的关联。从初次手术到全膝关节置换术翻修的平均时间为7.9年。许多患者（64.4%）有一个以上的失败原因。31%的患者为平均11个月的早期（< 2年）失败。这些患者感染、围手术期因素和合并症的患病率较高。晚期失效发生在平均119.2个月。其他主要失效原因包括不稳定（28.9%）、磨损（24.5%）和部件松动，这表明技术、植入物和其他领域改进的重要性。通过对全膝关节置换术实践的持续改进和对这些失效模式的进一步具体调查，这些发现的应用将最终减少翻修数量。
Although total knee arthroplasty is a very effective intervention and increasing in prevalence, failures do occur. We studied patients presenting for total knee arthroplasty revision to determine any modifiable causes of failure, both short and long term, and where future efforts should be directed to reduce the incidence of failure. A multicenter prospective observational cohort stud), of 318 consecutive patients, with minimum I year follow-up, undergoing total knee arthroplasty revision was performed. Associations between modes of failure were also assessed. The mean time from primary procedure to total knee arthroplasty revision was 7.9 years. Many patients (64.4%) had more than one cause of failure. Thirty-one percent of patients were early (< 2 years) failures at a mean of 11 months. These had a higher prevalence of infection, perioperative factors and comorbidities. Late failures occurred at a mean of 119.2 months. Other major causes of failure included instability (28.9%), wear (24.5%) and component loosening suggesting the importance of modifications in technique, implants and other areas. Application of these findings will ultimately reduce revision numbers through continued refinement of total knee arthroplasty practice and through further specific investigation of these modes of failure.