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- 您请求的操作仅限于组中的用户:==并发症及禁忌症== TKA术后可能出现的并发症:*感染*神经损伤*骨折(术中或术后)*持续性/[[慢性疼痛与脑|慢性疼痛]]Hasegawa M, Tone S, Naito Y, Wakabayashi H, Sudo A. [https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0038-1675415全膝关节置换术后持续性疼痛的患病率及神经性疼痛的影响。膝关节外科杂志,2018;32(10):1020-1023。Kim M ., Koh I, Sohn S ., Kang B ., Kwak D ., In Y. [https://www.sciencedirect.com/science/article/abs/pii/S0883540319302980]中枢敏感化是全膝关节置换术患者术后持续疼痛和不满意的危险因素。关节成形术杂志,2019;34(8):1740-1748。 *增加[[跌倒]]风险*[[深静脉血栓形成|深静脉血栓形成]](DVT) **膝关节或髋关节置换术后常见的并发症,可导致显著的发病率和死亡率**膝关节或髋关节置换术后DVT的发生率已报道为18%张辉,毛鹏,王超,陈丹,徐铮,石丹等。[https://www.ingentaconnect.com/content/wk/blcof/2017/00000028/00000002/art00003]全髋关节置换术后深静脉血栓形成(DVT)发生率及危险因素分析。凝血与纤溶,2016;28(2):126-133(8)。 **大型研究报道,高凝诊断/条件的患者在关节置换术后6个月内发生DVT的风险更大Bawa H, Weick J, Dirschl D, Luu H. [https://journals.lww.com/jaaos/fulltext/2018/10010/trends_in_deep_vein_thrombosis_prophylaxis_and.6.aspx全髋关节和膝关节置换术后深静脉血栓预防和深静脉血栓发生率的趋势。[j]中华骨科杂志,2018;26(19):698-705。 *僵硬 **原发性TKA后最常见的症状**影响约6%至7%的手术患者 **当代文献支持将“获得性特发性僵硬”定义为原发性TKA后活动范围<90°持续>12周,没有包括先前存在的僵硬在内的复杂因素。**僵硬会导致严重的功能障碍和较低的满意度Clement N, Bardgett M, Weir D, Holland J, Deehan D. [https://link.springer.com/article/10.1007/s00167-018-4979-2全膝关节置换术后1年僵硬症状增加与较差的功能预后和较低的患者满意度相关。[j]中国膝关节外科杂志,2018;27(4):1196-1203。 **女性和肥胖患者有增加风险的报道Tibbo M, Limberg A, Salib C, Ahmed A, van Wijnen A, Berry D等。[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641113/全膝关节置换术后获得性特发性僵硬。][j]中华骨外科杂志,2016;31(4):349 - 349。 **证据不推荐常规使用持续被动运动(CPM),因为长期临床和功能影响不显著,Wirries N, Ezechieli M, Stimpel K, Skutek M. [https://onlinelibrary.wiley.com/doi/10.1002/pri.1869持续被动运动对全膝关节置换术后康复的影响。国际物理治疗研究,2020;25(4)。梅耶M, Naylor J, Harris I, Badge H, Adie S, Mills K等。https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180090膝关节置换术急性护理过程的证据基础和实践差异。公共科学图书馆。 2017;12(7):e0180090. and not superior to traditional mobilisation techniquesTrzeciak T, Richter M, Ruszkowski K. Efektywność ciagłego biernego ruchu po zabiegu pierwotnej endoprotezoplastyki stawu kolanowego [[https://pubmed.ncbi.nlm.nih.gov/22708322/ Effectiveness of continuous passive motion after total knee replacement]]. Chirurgia Narzadów Ruchu i Ortopedia Polska. 2011;76(6):345-9. * Prosthesis-related complications: loosening or fracture of prosthesis components, joint instability and dislocation, component misalignment and breakdown ** While more research is needed for the long term failure rates of TKA implants, available arthroplasty registry data shows that 82% of TKA surgeries and 70% of unilateral knee replacement surgeries last 25 years in patients with osteoarthritis ** Polyethylene wear is a common cause for revision surgery * High-risk activities that may not be permitted, or require clearance with the orthopaedic surgeon, post-surgery: ** Singles tennis, squash/racquet ball ** Jogging ** High impact aerobics ** Mountain biking ** Soccer, football, volleyball, baseball/softball, handball, basketball ** Gymnastics ** Water-skiing/ water sports ** Skiing ** Skating