运用微创髌旁内侧入路行内侧单髁膝关节置换术  

Medial unicompartmental knee arthroplasty by minimally invasive medial parapatellar approach

作　　者：丁清和 张弛 侯之启 赵樑 

机构地区：[1]广州市正骨医院,510045

出　　处：《中华关节外科杂志（电子版）》2015年第4期30-33,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的评价运用微创髌旁内侧入路行内侧单髁膝关节置换术的临床效果。方法前瞻性分析2009年1月至2013年12月在广州市正骨医院膝关节外科用微创髌旁内侧入路行内侧单髁置换的41例患者(41膝),手术均采用Biomet OxfordⅢ骨水泥型人工单髁假体,随访时间最少12个月。根据术前Kujala膝前痛评分将所有病例分为膝前痛组(19例)和对照组(22例),记录并分析其手术前后的膝关节活动度,HSS评分及Kujala膝前痛评分,以评价其手术前后膝关节尤其是髌股关节功能的恢复程度。结果两组的术前和术后HSS评分、Kujala膝前痛评分存在统计学差异,膝前痛组的分值更低。两组术后HSS评分的提高程度无统计学差异,而Kujala膝前痛评分的提高则是膝前痛组更显著。结论运用微创髌旁内侧入路行内侧单髁膝关节置换术安全可行,创伤小,疗效良好,术中可观察、处理髌股关节病变,甚至改善髌骨轨迹,提示该入路对内侧间室合并髌股关节病变的患者更加适合。Objective To evaluate the clinical outcome of medial unicompartmental knee arthroplasty（ UKA） by minimally invasive medial parapatellar approach. Methods A total of 41 cases（ 41 knees） of medial UKA performed by minimally invasive medial parapatella approach with a Biomet Oxford Ⅲ cemented prothesis,were analyzed prospectively. The minimal follow-up time was 12 months.All the cases were defined into two groups,the anterior knee pain（ AKP） group（ 19 cases） and the control group（ 22 cases）,based on the Kujala AKP scoring. Rang of motion of the knee,HSS scores and Kujala AKP scores were recorded preoperatively and postoperatively to analyze the clinical outcomes of the knees,especially the functional recovery of the patellofemoral joint. Results Statistically significant difference was observed between the preoperative and the postoperative HSS scores as well as the preoperative and the postoperative Kujala AKP scores; the scores of the AKP group was lower than that of the control group. The increase of the HSS scores after the surgery showed no significant difference between the two groups,while the Kujala AKP scores increased significantly in the AKP group. Conclusions Medial UKA with minimally invasive medial parapatellar approach is safe,less invasive and effective. Surgeons are able to observe and treat the patellofemoral lesion even correct the patella tracking by this approach,which suggests that this approach may improve the outcomes of the patients with patellofemoral symptoms in medial compartment.

关 键 词：关节成型术 置换 膝 髌股关节 微创手术 

分 类 号：R687.4[医药卫生—骨科学]