全踝关节置换术专家共识  

Expert consensus on total ankle arthroplasty

作　　者：国家骨科医学中心首都医科大学附属北京积水潭医院足踝关节炎诊疗研究中心 武勇 许翔宇 赖良鹏 Research Center for Foot and Ankle Arthritis of Beijing Jishuitan Hospital,National Center for Orthopaedics;WU Yong

机构地区：[1]不详 [2]首都医科大学附属北京积水潭医院

出　　处：《中华骨与关节外科杂志》2024年第10期865-872,共8页Chinese Journal of Bone and Joint Surgery

摘　　要：踝关节炎(AA)是足踝外科最常见的疾病之一,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)。近年来,假体的升级迭代、手术技术的提高及个性化工具(PSI)系统的出现,使TAA的假体使用寿命延长,手术精度不断提高,预后不断改善。TAA已成为公认的治疗终末期AA的可选方案,其适应证范围也在不断扩大。目前,关于TAA的适宜年龄、术前畸形程度对TAA选择及预后的影响、软组织松解和重建的判断及选择等临床常见问题尚无相关专家共识或指南。由国家骨科医学中心首都医科大学附属北京积水潭医院足踝关节炎诊疗研究中心牵头,遵循循证医学原则,围绕TAA适应证与禁忌证、术前准备、术中技术要点、围手术期管理、术后康复及随访计划,通过多次会议讨论及问卷调查,整理完成《全踝关节置换术专家共识》,供广大足踝外科医师在临床工作中参考和应用。Ankle arthritis(AA)is one of the most common diseases in foot and ankle surgery.Ankle arthrodesis and total ankle arthroplasty(TAA)are the primary surgical options.Recent advancements in prostheses,surgical techniques,and personalized surgical instrument systems have extended lifespan of prostheses and improved surgical precision,enhancing TAA outcomes.TAA is now a widely accepted treatment for end-stage AA,with broadening indications.However,there is currently no expert consensus or recommendations on common clinical issues such as the optimal age range for TAA candidates,the impact of preoperative deformity on the choice and prognosis of TAA,and decision-making for soft tissue release and reconstruction.Therefore,led by the Research Center for Foot and Ankle Arthritis of Beijing Jishuitan Hospital,National Center for Orthopaedic,this consensus was developed following the principle of evidence-based medicine,and focusing on topics such as the indications and contraindications for TAA,preoperative preparation,intraoperative technical points,perioperative management,postoperative rehabilitation,and follow-up through multiple meetings and questionnaires.It serves as a reference and a practical guide for foot and ankle surgeons in their clinical practice.

关 键 词：踝关节 人工关节置换术 术中技术要点 围手术期管理 

分 类 号：R687.4[医药卫生—骨科学]