内侧固定平台与活动平台单髁置换对自发性膝关节骨坏死的疗效比较  

Comparison of the short-term and long-term curative effect of unicondylar replacement with medial fixed platform and movable platform on spontaneous knee osteonecrosis

作　　者：张春啸 孙艳凤 严斌 张长青[1] 刘东英 宋矿鹏 邱国良[1] ZHANG Chunxiao;SUN Yanfeng;YAN Bin(Department of Arthrosis,the Fourth People's Hospital of Hengshui,Hebei Province,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院关节骨一科,053000

出　　处：《临床外科杂志》2022年第7期670-672,共3页Journal of Clinical Surgery

基　　金：河北省衡水市重点研发技术项目(2019014091Z)。

摘　　要：目的对比内侧固定平台与活动平台单髁置换对自发性膝关节骨坏死(SONK)的疗效。方法2016年2月~2020年3月我院行单髁置换的SONK病人72例,依据所用单髁置换假体的不同分为内侧固定平台组(35例)和活动平台组(37例)。比较两组手术时间、术中出血量、膝关节活动范围(ROM)、膝关节协会(KSS)评分、膝关节美国特种外科医院(HSS)评分及下肢力线改变情况。随访2年,分析两组病人假体生存情况。结果两组病人手术时间及术中出血量对比,差异均无统计学差异(P>0.05)。与术前相比,术后6个月两组病人ROM、KSS评分及HSS评分、髋膝踝角均升高,胫股角均降低,差异有统计学意义(P<0.05);但术后6个月两组病人ROM、KSS评分、HSS评分、髋膝踝角、胫股角及胫骨后倾角对比,差异均无统计学(P>0.05)。两组病人假体生存曲线对比,差异无统计学意义(P>0.05)。结论采用内侧固定平台、活动平台单髁置换治疗SONK疗效相当。Objective To compare the short-and long-term effects of unicondylar replacement with medial fixed platform and movable platform on spontaneous osteonecrosis of the knee(SONK).Methods A retrospective analysis of 72 SONK patients who underwent unicondyle replacement in our hospital from February 2016 to March 2020 was divided into medial fixed platform group(35 cases)and movable platform group according to the difference of the unicondyle replacement prosthesis used by the patients(37 cases).The operation time,intraoperative blood loss,knee range of motion(ROM),Knee Society(KSS)score,American Hospital for Special Surgery(HSS)score and lower extremity alignment were compared between the two groups.After a 2-year follow-up,the prosthesis survival of the two groups was analyzed.Results There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).At 6 months after operation,the ROM,KSS score,HSS score,hip,knee and ankle angle of the two groups were all increased(P<0.05),while the tibiofemoral angle was decreased(P<0.05).There was no significant difference in ROM,KSS score,HSS score,hip-knee-ankle angle,tibiofemoral angle and tibial retroversion angle between the two groups at 6 months after operation(P>0.05).There was no significant difference in the survival curve of prosthesis between the two groups(P>0.05).Conclusion The treatment of SONK with medial fixed platform and movable platform unicondyle replacement is quite effective.

关 键 词：自发性膝关节骨坏死 内侧固定平台 活动平台 单髁置换 疗效 

分 类 号：R687.4[医药卫生—骨科学]