单髁置换治疗股骨外髁重度剥脱性骨软骨炎  

Unicompartmental knee arthroplasty for severe osteochondritis dissecans on lateral femoral condyle

作　　者：叶晔 刘又文 李无阴 孙永强 YE Ye;LIU You-wen;LI Wu-yin;SUN Yong-qiang(Department of Adult Joint Reconstruction,Henan Pro vincial Luoyang Orthopaedic Hospital,Luoyang450000,China;Department of Hip Injury,Henan Pro vincial Luoyang Orthopaedic Hospital,Luoyang450000,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)人工关节翻修科,河南洛阳450000 [2]:河南省洛阳正骨医院(河南省骨科医院)髋部损伤科,河南洛阳450000

出　　处：《中国矫形外科杂志》2020年第9期837-840,共4页Orthopedic Journal of China

摘　　要：[目的]介绍单髁置换治疗股骨外髁剥脱性骨软骨炎的手术技术与近期疗效。[方法]对11例股骨外髁重度剥脱性骨软骨炎患者行单髁置换术。行髌骨外侧入路,切开部分髂胫束,并保留其部分止点。显露完整的股骨外髁,清理股骨外髁后侧剥脱的关节软骨。由于股骨外髁后侧的骨缺损,术中无法安装股骨测量试件,均使用中小号假体。进行股骨截骨,测试伸直及屈膝间隙合适,安装相应股骨及胫骨金属托,置入合适厚度聚乙烯衬垫。[结果]本组患者均顺利手术,手术时间平均(52.48±10.21)min。术后平均住院时间(7.34±1.70)d,无严重并发症。随时间推移,KSS评分、VAS评分和膝关节ROM均显著改善(P<0.05)。[结论]外侧单髁置换能够明显缓解重度股骨外髁剥脱性骨软骨炎症状,改善膝关节功能,且手术创伤小、并发症少。[Objective]To introduce the surgical technique and primary clinical outcomes of unicompartmental knee arthro plasty(UKA)for severe osteochondritis dissecans on the lateral femoral condyle.[Methods]A total of 11 patients received UKA for severe osteochondritis dissecans on the lateral femoral condyle.A lateral parapatellar incision was made and the iliotibial tract was released with partial preservation of its tibial insertion.After exposure of the lateral femoral condyle,the osteochondral lesion was debrided.Only middle or small size prosthesis were selected due to no trials suitable subsequent to bone defect on the posterior condyle.As the femoral and tibial osteotomy conducted accurately,the femoral and tibial metal components were installed,and then the plastic insertion was placed.[Results]All the 11 patients had surgical procedures conducted successful ly with operation time of(52.48±10.21)min and postoperative hospital stay of(7.34±1.70)days.No serious complications oc curred in anyone of them.The KSS scores,VAS scores and knee ROM significantly improved over time.[Conclusion]This later al UKA does significantly alleviate symptoms and improve knee function for severe osteochondritis dissecans on the lateral femo ral condyle,has advantages of minimal iatrogenic trauma and few complications.

关 键 词：剥脱性骨软骨炎 膝关节 单髁置换术 

分 类 号：R687.4[医药卫生—骨科学]