单髁置换术治疗70岁以上老年膝内侧间室骨关节炎合并骨质疏松症的近期疗效观察  

Short-term Clinical Efficacy of Unicompartmental Knee Arthroplasty in the Treatment of Unicompartmental Knee Osteoarthritis with Osteoporosis

作　　者：许瀚 吕波[2] 赵永正 牟雅洁 Xu Han;Lv Bo;Zhao Yongzheng(Department of Joint Surgery,No.1 Orthopedics Hospital of Chengdu,Chengdu 610031,China;Department of Orthopedics,Sichuan People’s Hospital,Chengdu 610072,China;Chengdu Sport University,Chengdu 610041,China)

机构地区：[1]成都第一骨科医院关节科,四川成都610031 [2]四川省医学科学院,四川省人民医院骨科,四川成都610072 [3]成都体育学院,四川成都610041

出　　处：《实用骨科杂志》2020年第12期1075-1078,共4页Journal of Practical Orthopaedics

摘　　要：目的回顾性分析单髁置换术治疗70岁以上老年膝关节内侧间室骨关节炎合并骨质疏松症的近期临床疗效。方法选取2017年6月至2019年6月在四川省人民医院骨科行单髁置换术的70岁以上老年膝关节内侧间室骨关节炎合并骨质疏松的患者36例进行回顾性研究,其中男性15例,女性21例,年龄70~85岁,平均(76.3±4.3)岁。根据Kellgren-Lawrence(K-L)分级评分,Ⅲ级25例,Ⅳ级11例。分析患者术前及末次随访胫股角(femorotibial angle,FTA)、髋膝踝角(hip knee ankle angle,HKA)、下肢力线、主动最大活动度(range of motion,ROM)、视觉模拟评分(visual analogue scale,VAS)和特殊外科医院膝关节评分(hospital for special surgery knee score,HSS)的变化以及有无并发症发生等。结果所有患者均得到随访,随访时间6~24个月,平均(11.5±5.8)个月。患者末次随访HKA、FTA、ROM、VAS评分和HSS评分较术前均有显著改善(P<0.05),术后末次随访均无一例出现因骨质疏松及假体带来的术后相关并发症。结论老年膝关节骨关节炎患者合并骨质疏松在临床中较为常见,谨慎选择膝关节单髁假体,熟练掌握手术技术,术后积极进行抗骨质疏松治疗,单髁置换术可取得较为满意的临床疗效。Objective To retrospectively analyze the short-term clinical effect of single condyle replacement in the treatment of anterior medial compartment osteoarthritis of knee combined with osteoporosis in the aged over 70 years.Methods A retrospective study was conducted on 36 patients with antemedial knee osteoarthritis combined with osteoporosis who underwent unicondylar replacement in the department of Orthopedics of Sichuan People's Hospital from June 2017 to June 2019.According to Kellgreen-Lawrence(K-L)grading scores,there were 25 patients with gradeⅢand 11 patients with gradeⅣ.The changes of tibial femoral angle(FTA),hip,knee and ankle Angle(HKA),lower extremity line,active maximum range of motion(ROM),visual analog score(VAS)and knee joint score(HSS)in hospitals for special surgery,as well as the occurrence of complications were analyzed before and at the last follow-up.Results All patients were followed up and theaverage follow-up time was(11.5±5.8)months.HKA,FTA,ROM,VAS and HSS were significantly improved in the last follow-up(P<0.05).No postoperative complications caused by osteoporosis or prosthesis occurred in the last follow-up.Conclusion The elderly patients with osteoarthritis of the knee combined with osteoporosis is relatively common in clinical,the choice of the knee joint monondylar prosthesis careful,skilled the surgical techniques,postoperative active anti-osteoporosis,monondylar replacement are preferable satisfactory clinical efficacy.

关 键 词：内侧间室骨关节炎 单髁置换术 骨质疏松症 

分 类 号：R687.42[医药卫生—骨科学]