膝关节翻修幻灯片.ppt

Case Description: Patient, Sun * *, female, 65 years old. “The left knee was pain and limited 7 years after TKA” 7 years ago, due to left knee osteoarthritis, the patient taken TKA, 2 years later, the left knee joint occurred pain, the activity was limited. In the past six months, the patient pain increase, walk difficultly. Physical examination: knee joint range -10° - 0 -100 °. The lateral stress test (+) on the left knee joint, the skin sensation of both lower extremities and the peripheral blood transport were not obviously abnormal Auxiliary examination: ESR 8ml/h, CRP 10mg/L, Procalcitonin 0.08ng/L, Case Description: Preoperative appearance Preoperative buckling function The lateral stress test X-ray 术前X线 Question? Whether the prosthesis loosening combine with infection? The reasons of the loosening ? How to treat the bone defects? How do you adjust the joint lines? Block choice: thick liner or metal pad + thin liner? Our treatment option Exclusion of infection Dissolution bone/ the prosthesis loosening of the initial TKA Lcck metal pad + thin liner intra-operative image liner Serious bone loss Prosthesis choice After installing the implant Postoperative treatment: Prevention of infection: 24 hours of cefazoline sodium 1.5 mg twice Analgesic: before and after the operation, the nerve block and “cocktail” in the operation Anticoagulation: low molecular heparin calcium Functional exercise etc. The postoperative knee buckling function The lateral stress test after operation X-ray after operation Dissusion: The causes of knee joint bone dissolution: Implant chips The fixation of bone cement The knee space is large The synovial tissue is rich thanks 然后又进行了前关节囊，及髂腰肌的松解 * 然后又进行了前关节囊，及髂腰肌的松解 * 然后又进行了前关节囊，及髂腰肌的松解 * 然后又进行了前关节囊，及髂腰肌的松解 *