膝关节单髁置换术65例的中期随访效果分析  

Mid-term result of 65 cases of unicompartment knee arthroplasty

作　　者：张占丰[1] 王丹[1] 闵继康[1] 钟建明[1] 

机构地区：[1]湖州市第一人民医院骨科,浙江湖州313000

出　　处：《中国骨与关节外科》2016年第6期472-475,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:膝关节单髁置换术(unicompartment knee arthroplasty,UKA)因为假体的改进,其创伤小,骨量保存好,手术时间短,康复进程快等优点目前已受到关节外科医师的认可,在临床中得到广泛的应用。尽管其长期生存率良好,但仍有一些并发症的发生,需要在使用中引起注意。目的目的:随访总结UKA的临床结果和术后并发症,并讨论术后并发症可能的原因。方法方法:对2010年4月至2013年5月65例接受UKA的患者的临床资料进行回顾性研究。其中男27例,女38例。年龄50~82岁,平均62.3岁。BMI:18.3~30.1 kg/m^2,平均23.9 kg/m^2。取前后位膝关节负重全长X线片,分别测量手术前后的股胫角。术后1个月、3个月、12个月随访患者,之后每年随访时评估膝关节功能,随访时使用膝关节HSS评分对膝关节功能进行评估。结果结果:术前、术后3个月、术后24个月的HSS评分分别为(75.06±3.29)分、(84.31±4.58)分、(87.09±4.63)分,股胫角分别为182.75°±3.92°、177.26°±3.01°、178.92°±5.25°。术后3个月和24个月的HSS评分,与术前相比,显著增加(P<0.05),而术后3个月和24个月的股胫角,与术前相比,显著减小(P<0.05)。随访期间观察到的并发症包括:膝关节肿胀11例,持续性膝关节痛3例,聚乙烯衬垫脱位3例。随访时间24~50个月,平均30.5个月,有3例因聚乙烯衬垫脱位进行翻修,随访期间假体生存率为95.4%。结论结论:UKA在准确把握适应证的前提下,其术后效果值得肯定。聚乙烯衬垫脱位、术后持续性膝关节痛和膝关节肿胀是值得关注的并发症。Background： As the improvement of the design of prosthesis,unicompartment knee arthroplasty（UKA） has been accepted by surgeons because of lots of advantages such as limited invasion,good bone preservation,short operating time,and fast rehabilitation. Although the long term follow-up was excellent,UKA had its own complications that should been paid attention.Objective： To observe the clinical outcome and complications of UKA,and to discuss the possible reason of the complications. Methods： Sixty-five patients undergoing UKA from April 2010 to May 2013 were enrolled in this study. There were 27 males and 38 females with a mean age of 62.3 years（range,50-82 years）. The mean Body mass index（BMI） was 23.9 kg/m^2（range,18.3-30.1 kg/m^2）. These patients were assessed radiographically in femorotibial angle（FTA）both preoperatively and postoperatively with standing anteroposterior radiographs and the knee function according to HSS grading. Results： The mean HSS score was 75.06 ± 3.29,84.31 ± 4.58 and 87.09 ± 4.63 preoperatively,3 months and 24 months postoperatively,respectively; the mean FTA was 182.75°±3.92°,177.26°±3.01° and 178.92°±5.25°. Compared with preoperative ones,HSS score was signifcantly increased,while FTA was significantly decreased at 3 months and 24 months postoperatively（P〈0.05）. Postoperative complications included knee swelling in 11 cases,persistent knee pain in 3 cases,bearing dislocation in 3 cases. The mean duration of follow-up was 30.5 months（range,24-50 months）. Revision was performed in the 3 patient with bearing dislocation,and he survival rate of prothesis was 95.4%. Conclusions： UKA can achieve satisfying outcome by indication obeyed. Knee swelling,persistent knee pain and bearing dislocation are the main comlications which should be paid more attention.

关 键 词：膝 膝关节单髁置换术 术后并发症 

分 类 号：R687.4[医药卫生—骨科学]