目的 总结聚丙烯网状补片加强缝合辅助修复 3 例人工全膝关节置换术（total knee arthroplasty，TKA）髌腱断裂的远期疗效。方法 2007 年 8 月—2009 年 7 月，3 例类风湿性关节炎患者于 TKA 术中或术后发生髌腱断裂。其中男 1 例，女 2 例；年龄分别为 58、63、69 岁。2 例有类固醇长期使用史。经 Krackow 法缝合（1 例）或自体肌腱重建（2 例）后，采用聚丙烯网状补片加强固定。记录并比较患者重建术后伸膝迟滞、股四头肌肌力、膝关节活动度和膝关节学会评分系统（KSS）评分。结果 术后患者分别获随访 10.4、11.0、6.5 年。随访期间无感染和假体松动发生。末次随访时，TKA 术中髌腱断裂患者膝关节 KSS 评分达 90 分，未见伸膝迟滞；术后髌腱断裂患者膝关节 KSS 评分达 90、85 分，残留伸膝迟滞 5°、10°。结论 TKA 髌腱断裂后选择聚丙烯网状补片加强缝合辅助修复，患者远期膝关节功能良好，但应用例数有限，其确切疗效仍需扩大病例数量进一步验证。
Citation：
马云青, 张蔷, 张洪. 聚丙烯网状补片加强缝合辅助修复人工全膝关节置换术髌腱断裂三例. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(9): 1205-1207. doi: 10.7507/1002-1892.202002127
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- 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.
