■由于解剖结构改变,前交叉韧带(ACL)重建后的膝关节置换可能要求很高,软组织疤痕,骨丢失,伸肌机制并发症,膝盖不稳定。这篇叙述性综述总结了ACL重建后全膝关节置换术(TKA)中应对手术挑战的策略和方法。
■报告ACL重建后接受TKA的患者结局的研究被检索并评估为纳入本综述,该综述综合了突出手术中遇到的陷阱的现有证据。韧带平衡和暴露带来的术中挑战,以及模块化和保留植入物的主导作用。
■ACL重建后的TKA术中并发症的发生率很高,例如不稳定,骨丢失,暴露困难和要求软组织平衡,代表翻修手术而不是常规的初次膝关节置换术,并且推荐针对翻修的技能集和模块化组件,以显著优化手术策略和患者结局.随着ACL损伤的发生率上升和重建的增加,预计TKA程序会增加,这篇综述旨在呼吁人们重新思考临床方法,以确保有效和以患者为中心的护理。
■此叙述性回顾似乎表明,ACL重建后的TKA应视为翻修手术,并应使用模块化组件。然而,未来的前瞻性和高质量研究需要更好地阐明风险因素,并为这种复杂的手术提供强有力的建议.
UNASSIGNED: Knee replacement following anterior cruciate ligament (ACL) reconstruction can be demanding due to altered anatomy, soft tissue scars, bone loss, extensor mechanism complications, and knee instability. This narrative review summarizes the strategies and approaches to managing operative challenges in total knee arthroplasty (TKA) following ACL reconstruction.
UNASSIGNED: Studies reporting outcomes of patients who underwent TKA after ACL reconstruction were retrieved and assessed to be included in this review that synthesizes the available evidence highlighting the pitfalls encountered during surgery, the intraoperative challenges posed by ligament balancing and exposure, and the leading role of modular and retained implants.
UNASSIGNED: TKA following ACL reconstruction has a high rate of intra-operative complications such as instability, bone loss, difficult exposure and demanding soft tissue balancing, representing a revision surgery rather than routine primary knee arthroplasty and a revision-oriented skill set and modular components are recommended to significantly optimize both surgical strategy and patient outcomes. With a rising incidence of ACL injuries and growing reconstructions, anticipating an increase in TKA procedures, this review aims to provide a call for rethinking clinical approaches to ensure effective and patient-centric care.
UNASSIGNED: This narrative review seems to indicate that TKA after ACL reconstruction should be considered as revision surgery and modular components should be used. However, future prospective and high-quality studies are required to better clarify risk factors and give strong recommendations for this complex surgery.