膝关节固定平台单髁假体置换的中期随访评价  

A mid-term clinical follow-up of unicompartmental knee arthroplasty with fixed bearing

作　　者：王卫刚[1] 杨植栋 冯宗权[1] 王鼎 Wang Weigang;Yang Zhidong;Feng Zongquan;Wang Ding(Department of Arthrosis,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong Province,China)

机构地区：[1]佛山市中医院关节科,广东省佛山市528000

出　　处：《中国组织工程研究》2021年第3期368-373,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省医学科学技术研究(20161181228306),项目参与人:王卫刚~~。

摘　　要：背景:国内外大多数文献报道了活动平台单髁置换的中远期疗效,而对于固定平台单髁置换的中远期临床效果报道较少,同时大部分研究未分析固定平台单髁置换后不同时间点膝关节功能恢复及下肢力线改变情况,也忽视了对单髁置换后患者自我感觉情况的随访。目的:探讨膝关节固定平台单髁置换治疗膝关节内侧间室骨关节炎的中期临床效果,同时观察下肢力线改变情况。方法:回顾性分析2014年1月至2015年1月在佛山市中医院关节科诊断为膝关节内侧间室骨性关节炎患者的临床资料,按照纳入与排除标准,纳入行固定平台单髁置换66例患者,其中男18例,女48例,平均年龄(62.36±16.33)岁,分别在治疗前和治疗后1,3,5年采用美国膝关节协会评分(knee society knee score,KSS评分)、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS评分)系统评估膝关节功能,采用目测类比评分评估膝关节疼痛严重程度,采用人工关节被遗忘指数评分评估单髁置换后假体自我主观感觉情况,治疗前和随访时拍摄双下肢负重全长X射线片测量髋-膝-踝角及胫股角评估下肢力线情况。结果与结论:①所有患者随访时间五六年,平均5.5年,切口均Ⅰ期愈合,无关节感染和下肢深静脉血栓形成等早期并发症发生,均无假体松动、脱位及对侧间室和髌股关节病变;②治疗后1,3,5年KSS临床评分、KSS功能评分、HSS评分、膝关节活动度、目测类比评分均低于治疗前(P<0.05),治疗后3,5年KSS临床评分、KSS功能评分、膝关节活动度、目测类比评分低于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);③治疗后3,5年人工关节被遗忘指数评分高于治疗后1年(P<0.05),治疗后3年与治疗后5年相比较,差异无显著性意义(P>0.05);④所有患者治疗后髋-膝-踝角、胫股角较治疗前均有明显改善(P<0.05),治疗后1,3BACKGROUND:Most of the domestic and foreign literatures reported the mid-term and long-term effects of the unicompartmental knee arthroplasty of the mobile bearing,but few reported the mid-term and long-term clinical effects of the unicompartmental knee arthroplasty of the fixed bearing.Simultaneously,most of the studies did not analyze the knee function recovery and the lower limb force line change at different time points after the fixed bearing unicompartmental knee arthroplasty,and also ignored the follow-up of the patients’self-feeling after the unicompartmental knee arthroplasty.OBJECTIVE:To explore the mid-term clinical effect of fixed bearing unicompartmental knee arthroplasty in the treatment of medial compartment osteoarthritis of knee joint and to observe the change of force line of lower limbs.METHODS:From January 2014 to January 2015,a retrospective analysis was made of the data of 66 patients diagnosed as osteoarthritis of the medial compartment of the knee in the Department of Arthritis,Foshan Hospital of Traditional Chinese Medicine.According to the inclusion and exclusion criteria,66 patients were included,including 18 males and 48 females,aged(62.36±16.33)years.The American Knee Society knee score and the hospital for special surgery knee score were used to assess the knee function before and 1,3 and 5 years after the operation.Visual analogue scale score was utilized to evaluate the severity of knee.Forgotten joint score was used to assess the subjective feeling of prosthesis after unicompartmental knee arthroplasty.Hip-knee-ankle angle and tibiofemoral angle were measured using X-ray films before treatment and at follow-up to evaluate the force line of weight-bearing lower limbs.RESULTS AND CONCLUSION:(1)The postoperative follow-up time was 5-6 years,averagely 5.5 years.The incision healed in the first stage.There was no early complication such as joint infection or lower extremity deep vein thrombosis,and there was no prosthesis loosening,dislocation or other diseases of the contralateral

关 键 词：骨 膝关节 单髁 置换 固定平台 下肢力线 人工关节 遗忘指数 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]