铰链式人工膝关节置换治疗脊髓痨引发夏科氏关节1例  

Hinged total knee arthroplasty for Charcot joints caused by tabes dorsalis:One case report

作　　者：殷增光[1] 赵劲松[1] 杨腾[1] 张满江[1] 黄岚峰[1] 

机构地区：[1]吉林大学白求恩第二医院骨科,吉林省长春市130041

出　　处：《中国组织工程研究》2012年第13期2467-2470,共4页Chinese Journal of Tissue Engineering Research

基　　金：吉林省科技发展计划项目(200705242;20080738)~~

摘　　要：背景:通常认为神经梅毒引发的夏科氏关节是膝关节置换的禁忌证,国内尚未见详尽的个案报道,国外已有报道,但置换后并发症较多。目的:回顾由于实质型神经梅毒引发的夏科氏关节的治疗现状。方法:系统复习国内外文献摘要30余篇,总结了神经梅毒的诊治方案及由此引发的夏科氏关节外科置换治疗。结果与结论:血清、脑脊液检查结合典型的临床症状、体征可明确诊断脊髓痨,青霉素是有效治疗脊髓痨的一线用药,夏科氏关节病变晚期可行全膝关节置换。铰链式膝关节置换可有效治疗夏科氏关节,明显改善膝关节功能。BACKGROUND：Usually,the Charcot joint caused by neurosyphilis is regarded as a contraindication for total knee arthroplasty（TKA）,and there are case reports in abroad but not in China.However,there are many complications after replacement.OBJECTIVE：To review the therapy progress of Charcot joints caused by substantial neurosyphilis.METHODS：More than 30 scientific civil and foreign literatures were reviewed scientifically to summarize the diagnosis and treatment scheme of neurosyphilis,as well as the surgical therapy of the Charcot joints caused by tabes dorsalis.RESULTS AND CONCLUSION：Serum and cerebrospinal fluid check combined with typical clinical symptoms and signs could be diagnosed as the tabes dorsalis definitely.Penicillin is the first-line pharmaceutical apply for tabes dorsalis.Late-stage Charcot joints lesions may be treated with the TKA.Hinged TKA can cure the Charcot joints and improve the function of knee joints obviously.

关 键 词：铰链式人工膝关节 夏科氏关节 脊髓 神经梅毒 全膝置换 假体 

分 类 号：R318[医药卫生—生物医学工程]