摘要
足踝创伤是踝关节炎的主要病因。终末期踝关节炎会引起踝关节严重疼痛及功能受限,严重影响生活质量,目前常用的外科治疗方式主要为踝关节融合术及全踝关节置换术(TAA)。早期TAA有较高的手术并发症和失败率。近年来,随着踝关节生物力学研究不断深入,迭代的假体和手术技术已经使TAA的预后和假体的使用寿命不断提高,个性化定制假体的出现进一步提高了TAA的手术精度。TAA已成为治疗终末期踝关节炎的公认可选方案,其适应证范围也在不断扩大,并发症包括内踝骨折、踝关节撞击、骨质溶解和异位骨化等,新型假体5年随访翻修率明显降低。与踝关节融合术相比,TAA可使步态更符合生理要求,但其优势仍需要更多高质量的长期随访研究来证实与阐明。
Foot and ankle trauma is the main cause of ankle osteoarthritis(AO).End-stage AO can cause severe pain and functional limitation of the ankle joint,which seriously affects the quality of life.The common surgical treatments are ankle arthrodesis and total ankle arthroplasty(TAA).Early TAA has a high rate of surgical complications and failure.In recent years,innovative implants and surgical techniques have led to improved prognosis and longevity of implants,and the advent of patient-specific instrumentation has further improved the surgical precision of TAA.TAA has become a recognized option for the treatment of end-stage AO,and its range of indications continues to expand.The complications of TAA include medial malleolus fracture,ankle impingement,osteolysis,and heterotopic ossification.The 5-year follow-up revision rate of new implants was significantly decreased.TAA allows for a more physiological gait than ankle arthrodesis,but its benefits need to be confirmed and elucidated in more high-quality,long-term follow-up studies.
作者
许翔宇
武勇
XU Xiangyu;WU Yong(Department of Foot and Ankle Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处
《中华骨与关节外科杂志》
CSCD
2023年第8期750-755,共6页
Chinese Journal of Bone and Joint Surgery
基金
北京市卫健委适宜技术推广(BHTPP2022078)。
