PDF(Pubmed)
Abstract：
UNASSIGNED: Knee osteoarthritis is common among older individuals, necessitating Total Knee Arthroplasty (TKA) for end-stage cases. The aging population has increased TKA demand, leading to a rise in revision surgeries. Genu recurvatum, a rare complication, often requires surgical intervention, with late-onset cases linked to neuromuscular conditions. This case series focuses on the infrequent occurrence of late-onset genu recurvatum resulting from spinal stenosis in patients without other predisposing conditions.
UNASSIGNED: A retrospective case series of 10 patients (11 knees) referred between February 2016 and August 2020 due to late recurvatum instability. Exclusion criteria encompassed neuromuscular diseases other than spinal stenosis, prosthetic joint infection, and pre-existing recurvatum deformity. Data, including demographics, medical history, imaging findings, and surgical details, were collected retrospectively. Patient performance was assessed using the Knee Society Score (KSS) at specified postoperative intervals.
UNASSIGNED: The study cohort, exhibiting hyperextension ranging from 11 to 30 degrees, underwent successful revision surgery using rotating hinge knee (RHK) implants after failed conservative measures. Follow-up assessments at 6, 18, and 24 months showed no recurrence of genu recurvatum.
UNASSIGNED: Late-onset genu recurvatum poses a challenge, necessitating surgical intervention. Identifying predisposing factors is crucial, with spinal stenosis emerging as a rare cause. The use of posterior stabilized (PS) implants in primary surgery aligns with higher revision rates, possibly linked to PCL removal. Limited literature explores the spinal-genu recurvatum relationship. A stepwise screening protocol is proposed for high-risk patients, emphasizing history, physical examination, and imaging. Strategic considerations include lower constraining, a tighter extension gap, and potential use of Hinge implants.
UNASSIGNED: A retrospective case series of 10 patients (11 knees) referred between February 2016 and August 2020 due to late recurvatum instability. Exclusion criteria encompassed neuromuscular diseases other than spinal stenosis, prosthetic joint infection, and pre-existing recurvatum deformity. Data, including demographics, medical history, imaging findings, and surgical details, were collected retrospectively. Patient performance was assessed using the Knee Society Score (KSS) at specified postoperative intervals.
UNASSIGNED: The study cohort, exhibiting hyperextension ranging from 11 to 30 degrees, underwent successful revision surgery using rotating hinge knee (RHK) implants after failed conservative measures. Follow-up assessments at 6, 18, and 24 months showed no recurrence of genu recurvatum.
UNASSIGNED: Late-onset genu recurvatum poses a challenge, necessitating surgical intervention. Identifying predisposing factors is crucial, with spinal stenosis emerging as a rare cause. The use of posterior stabilized (PS) implants in primary surgery aligns with higher revision rates, possibly linked to PCL removal. Limited literature explores the spinal-genu recurvatum relationship. A stepwise screening protocol is proposed for high-risk patients, emphasizing history, physical examination, and imaging. Strategic considerations include lower constraining, a tighter extension gap, and potential use of Hinge implants.
摘要：
■膝关节骨性关节炎在老年人中很常见，终末期病例需要全膝关节置换术（TKA）。人口老龄化增加了TKA需求,导致翻修手术的增加。Genurecurvatum,一种罕见的并发症,通常需要手术干预，迟发性病例与神经肌肉疾病有关。此病例系列集中于在没有其他易感因素的患者中，由于椎管狭窄而导致的迟发性膝复发很少发生。
■回顾性病例系列，包括2016年2月至2020年8月因晚期复发不稳定而转诊的10例患者（11膝）。排除标准包括除椎管狭窄以外的神经肌肉疾病，假肢关节感染,和预先存在的递归畸形。数据,包括人口统计，病史,影像学发现，和手术细节，是回顾性收集的。在指定的术后间隔使用膝关节协会评分（KSS）评估患者的表现。
■研究队列，表现出11到30度的过度伸展，保守措施失败后，使用旋转铰链膝关节（RHK）植入物进行了成功的翻修手术。在6、18和24个月的随访评估显示没有复发。
■迟发性回复性带来了挑战，需要手术干预。识别诱发因素至关重要，椎管狭窄是一种罕见的病因。在初级手术中使用后稳定（PS）植入物与较高的翻修率一致，可能与PCL移除有关。有限的文献探讨了脊柱-膝曲关系。针对高危患者提出了逐步筛查方案，强调历史，体检,和成像。战略考虑包括较低的约束，更紧密的延伸间隙，以及铰链植入物的潜在用途。
■回顾性病例系列，包括2016年2月至2020年8月因晚期复发不稳定而转诊的10例患者（11膝）。排除标准包括除椎管狭窄以外的神经肌肉疾病，假肢关节感染,和预先存在的递归畸形。数据,包括人口统计，病史,影像学发现，和手术细节，是回顾性收集的。在指定的术后间隔使用膝关节协会评分（KSS）评估患者的表现。
■研究队列，表现出11到30度的过度伸展，保守措施失败后，使用旋转铰链膝关节（RHK）植入物进行了成功的翻修手术。在6、18和24个月的随访评估显示没有复发。
■迟发性回复性带来了挑战，需要手术干预。识别诱发因素至关重要，椎管狭窄是一种罕见的病因。在初级手术中使用后稳定（PS）植入物与较高的翻修率一致，可能与PCL移除有关。有限的文献探讨了脊柱-膝曲关系。针对高危患者提出了逐步筛查方案，强调历史，体检,和成像。战略考虑包括较低的约束，更紧密的延伸间隙，以及铰链植入物的潜在用途。
