单髁置换术治疗膝骨性关节炎227例临床报道  

Unicompartmental knee arthroplasty for knee osteoarthritis:a 227-case report

作　　者：邓迎杰[1] 梁治权[1] 方锐[1] DENG Ying-Jie;LIANG Zhi-quan;FANG Rui(Traditional Chinese Medicine Hospital affiliated to Xinjiang Medical University,Urumqi 83000,China)

机构地区：[1]新疆医科大学附属中医医院,乌鲁木齐830000

出　　处：《中国矫形外科杂志》2018年第17期1555-1559,共5页Orthopedic Journal of China

摘　　要：[目的]评价单髁置换术(UKA)治疗内侧单间膝骨性关节炎的临床疗效,总结该手术方式在治疗膝骨性关节炎单间室病变中的优势与特点。[方法]回顾2011年6月~2016年12月在本院确诊为膝骨性关节炎并行内侧间室UKA手术治疗的患者227例(235膝),对上述患者术前及术后影像学资料(髋-膝-踝角)、关节活动度(ROM)、膝关节HSS评分及牛津膝关节评分结果进行综合分析并总结。[结果]所有患者均顺利手术,无血管、神经损伤等严重并发症。其中211例患者获得随访,随访时间6~66个月,平均(35.21±21.85)个月,所有患者均未见感染、假体松动等并发症,但2例患者术后发生聚乙烯衬垫脱位,1例内侧胫骨平台骨折,1例无明显原因膝前痛。患者膝关节HSS评分由术前(58.27±7.93)分改善至末次随访时(91.61±5.45)分,差异有统计学意义(P<0.05);牛津膝关节评分由(42.62±4.12)分改善至(19.38±3.24)分,差异有统计学意义(P<0.05)。但关节活动度(ROM)由(123.11±9.55)°稍有改善至(125.64±11.26)°,差异无统计学意义(P>0.05)。影像资料评估显示髋-膝-踝角由术前(172.14±6.32)°改善至末次随访(175.51±4.26)°,差异有统计学意义(P<0.05)。[结论]UKA作为膝骨性关节炎阶梯治疗的重要组成部分,可有效治疗膝关节单间室病变,中短期临床疗效肯定,且患者易接受、满意度高。[Objective] To evaluate the clinical outcomes of the unicompartmental knee arthroplasty（UKA） for medial compartment knee osteoarthritis,summarize the advantages and characteristics of this procedure.[Methods] A retrospective study was conducted on 227 patients（235 knees） who underwent UKA for medial compartment knee osteoarthritis from June 2011 to December 2016 in our hospital.The radiographic data,such as hip-knee-ankle angle,as well as range of motion（ROM）,the Hospital for Special Surgery score（HSS） and Oxford knee score were used for evaluation of the clinical consequences.[Results]All the patients had UKA performed successfully without serious complications,such as neurovascular injuries.Of them,211 patients were followed up for 6 to 66 months with an average of（35.21±21.85） months.No infection and prosthetic loosening happened in anyone of them,however,dislocation of polyethylene liner occurred in 2,medial tibial plateau fracture in 1 and anterior knee pain of unknown reason in 1 patient.The HSS score significantly enhanced from（58.27±7.93） preoperatively to（91.61±5.45） at the latest follow up（P〈0.05）,while the Oxford knee score statistically decreased from（42.62±4.12） before operation to（19.38±3.24） at the last follow up（P〈0.05）.However,the ROM had only slight improvement from（123.11±9.55）° preoperatively to（125.64±11.26）° at the latest follow-up without statistical significance（P〉0.05）.In addition,the hip-knee-ankle angle significantly improved from（172.14±6.32）° to（175.51±4.26）°（P〈0.05）.[Conclusion] The UKA,an important part of step treatment of knee osteoarthritis,does achieve satisfactory short-medium-term clinical outcomes for merely medial compartment pathology with advantage of easily accepted by patients and high satisfaction.

关 键 词：单髁置换术 膝关节 骨性关节炎 临床疗效 

分 类 号：R687.4[医药卫生—骨科学]