聚丙烯網狀補片加強縫合輔助修復人工全膝關節置換術髕腱斷裂三例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

馬云青 , 張薔 ,  張洪

中國人民解放軍總醫院第四醫學中心關節外科（北京 100048）;

Corresponding?author：

張洪, Email: zhanghongmd@163.com

Keywords：

人工全膝關節置換術; 髕腱斷裂; 聚丙烯網狀補片; 修復重建

DOI：

10.7507/1002-1892.202002127

Video：

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目的總結聚丙烯網狀補片加強縫合輔助修復 3 例人工全膝關節置換術（total knee arthroplasty，TKA）髕腱斷裂的遠期療效。方法 2007 年 8 月—2009 年 7 月，3 例類風濕性關節炎患者于 TKA 術中或術后發生髕腱斷裂。其中男 1 例，女 2 例；年齡分別為 58、63、69 歲。2 例有類固醇長期使用史。經 Krackow 法縫合（1 例）或自體肌腱重建（2 例）后，采用聚丙烯網狀補片加強固定。記錄并比較患者重建術后伸膝遲滯、股四頭肌肌力、膝關節活動度和膝關節學會評分系統（KSS）評分。結果術后患者分別獲隨訪 10.4、11.0、6.5 年。隨訪期間無感染和假體松動發生。末次隨訪時，TKA 術中髕腱斷裂患者膝關節 KSS 評分達 90 分，未見伸膝遲滯；術后髕腱斷裂患者膝關節 KSS 評分達 90、85 分，殘留伸膝遲滯 5°、10°。結論 TKA 髕腱斷裂后選擇聚丙烯網狀補片加強縫合輔助修復，患者遠期膝關節功能良好，但應用例數有限，其確切療效仍需擴大病例數量進一步驗證。

Citation： 馬云青, 張薔, 張洪. 聚丙烯網狀補片加強縫合輔助修復人工全膝關節置換術髕腱斷裂三例. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(9): 1205-1207. doi: 10.7507/1002-1892.202002127 Copy

1.	Bonnin M, Lustig S, Huten D. Extensor tendon ruptures after total knee arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S21-31.
2.	Cottino U, Abdel MP, Hanssen AD, et al. Chronic extensor mechanism insufficiency in total knee arthroplasty. Curr Rev Musculoskelet Med, 2015, 8: 368-372.
3.	Rosenberg AG. Management of extensor mechanism rupture after TKA. J Bone Joint Surg (Br), 2012, 94(11 Suppl A): 116-119.
4.	Camarda L, D’Arienzo A, Morello S, et al. Bilateral ruptures of the extensor mechanism of the knee: a systematic review. J Orthop, 2017, 14(4): 445-453.
5.	Burnett RS, Berger RA, Della Valle CJ, et al. Extensor mechanism allograft reconstruction after total knee arthroplasty. J Bone Joint Surg (Am), 2005, 87(Pt 2): 175-194.
6.	Usher FC, Gannon JP. Marlex mesh, a new plastic mesh for replacing tissue defects.Ⅰ. Experimental studies. AMA Arch Surg, 1959, 78(1): 131-137.
7.	Robinson TN, Clarke JH, Schoen J, et al. Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc, 2005, 19(12): 1556-1560.
8.	Abdel MP, Salib CG, Mara KC, et al. Extensor mechanism reconstruction with use of marlex mesh: a series study of 77 total knee arthroplasties. J Bone Joint Surg (Am), 2018, 100(15): 1309-1318.
9.	Perry KI, Salib CG, Larson DR, et al. Two-stage exchange and Marlex-mesh reconstruction for infection with extensor mechanism disruption after total knee arthroplasty. J Bone Joint Surg (Am), 2018, 100(17): 1482-1489.

1. Bonnin M, Lustig S, Huten D. Extensor tendon ruptures after total knee arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S21-31.
2. Cottino U, Abdel MP, Hanssen AD, et al. Chronic extensor mechanism insufficiency in total knee arthroplasty. Curr Rev Musculoskelet Med, 2015, 8: 368-372.
3. Rosenberg AG. Management of extensor mechanism rupture after TKA. J Bone Joint Surg (Br), 2012, 94(11 Suppl A): 116-119.
4. Camarda L, D’Arienzo A, Morello S, et al. Bilateral ruptures of the extensor mechanism of the knee: a systematic review. J Orthop, 2017, 14(4): 445-453.
5. Burnett RS, Berger RA, Della Valle CJ, et al. Extensor mechanism allograft reconstruction after total knee arthroplasty. J Bone Joint Surg (Am), 2005, 87(Pt 2): 175-194.
6. Usher FC, Gannon JP. Marlex mesh, a new plastic mesh for replacing tissue defects.Ⅰ. Experimental studies. AMA Arch Surg, 1959, 78(1): 131-137.
7. Robinson TN, Clarke JH, Schoen J, et al. Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc, 2005, 19(12): 1556-1560.
8. Abdel MP, Salib CG, Mara KC, et al. Extensor mechanism reconstruction with use of marlex mesh: a series study of 77 total knee arthroplasties. J Bone Joint Surg (Am), 2018, 100(15): 1309-1318.
9. Perry KI, Salib CG, Larson DR, et al. Two-stage exchange and Marlex-mesh reconstruction for infection with extensor mechanism disruption after total knee arthroplasty. J Bone Joint Surg (Am), 2018, 100(17): 1482-1489.

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Chinese Journal of Reparative and Reconstructive Surgery

聚丙烯網狀補片加強縫合輔助修復人工全膝關節置換術髕腱斷裂三例

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