活动与固定平台单髁关节置换术短期疗效对比  

Comparison of Fixed-Bearing and Mobile-Bearing Unicompartmental Knee Arthroplasty in Short-term Outcome

作　　者：李金凤 路玉峰 乔锋 张保刚 贾斌[2] 贺金龙 许兆辰 钟豪良 任敬 Li Jinfeng;Lu Yufeng;Qiao Feng*;Zhang Baogang;Jia Bin;He Jinlong;Xu Zhaochen;Zhong Haoliang;Ren Jing(Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,China;Department of Orthopaedics,Honghui Hospital Affiliated to Xi’an Jiaotong University,Xi’an 710054,China)

机构地区：[1]陕西中医药大学,陕西咸阳712000 [2]西安交通大学附属红会医院中西医结合骨科,陕西西安710054

出　　处：《实用骨科杂志》2022年第10期892-897,共6页Journal of Practical Orthopaedics

基　　金：陕西省重点研发计划项目(2019SF-214);陕西省重点研发计划项目(2018SF-195);中医药传承创新暨“秦药”开发重点科学研究项目(2021-04-22-006)。

摘　　要：目的对比活动平台与固定平台膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)治疗膝关节内侧骨关节炎的短期疗效。方法回顾性分析2017年1月至2019年12月在西安交通大学附属红会医院中西医结合骨科收治的124例膝关节内侧骨关节炎患者,均采用UKA治疗。64例患者使用第2代LINK固定平台Sled假体(固定平台组),其中男18例,女46例;年龄50~83岁,平均(66.2±7.7)岁。60例患者使用第4代Oxford活动平台假体(活动平台组),其中男10例,女50例;年龄53~82岁,平均(63.4±7.1)岁。对比两组术前及术后美国膝关节协会评分(knee society score,KSS)、功能评分、机械股胫角(mechanical femorotibial angle,mFTA),术后胫骨假体内翻角、股骨假体外翻角以及胫骨假体后倾角。结果随访时间28~44个月,平均(36.0±7.3)个月。术后两组均未出现感染、衬垫脱位、骨折、症状性下肢深静脉血栓、无菌性松动等并发症。Sled假体UKA术后胫骨假体内翻明显大于Oxford假体,差异有统计学意义(P=0.036)。两种假体KSS评分和功能评分术后较术前均得到明显改善(P<0.001)。尽管Sled假体UKA术后KSS评分和功能评分高于Oxford假体,但两者比较差异无统计学意义(P>0.05)。结论固定平台UKA与活动平台UKA均获得了良好的临床与影像学结果,两者短期内疗效差异无统计学意义。Objective To compare mobile and fixed-bearing unicompartmental knee arthroplasty(UKA)for the treatment of medial osteoarthritis of the knee.Methods From January 2017 to December 2019,124 patients with medial knee osteoarthritis admitted to Department of Orthopaedics of Honghui Hospital Affiliated to Xi’an Jiaotong University were retrospectively analyzed.All patients were treated with UKA.A total of 64 patients(18 males and 46 females)used the second generation LINK fixed platform Sled prosthesis(fixed platform group).The average age was(66.2±7.7)years(range:50~83 years).Sixty patients(10 males and 50 females)used the 4th generation Oxford mobile platform prosthesis(mobile platform group).The average age was(63.4±7.1)years(range:53~82 years).The knee society score(KSS),functional score,mechanical femorotibial angle(mFTA),postoperative varus angle of tibia prosthesis and valgus angle of femoral prosthesis,and posterior inclination angle of tibial prosthesis were compared between the two groups before and after operation.Results The mean follow-up time was(36.0±7.3)months(range:28~44 months).There were no complications such as infection,pad dislocation,fracture,symptomatic deep vein thrombosis and aseptic loosening in both groups.Sled prosthesis had more varum than Oxford prosthesis after UKA,and the difference was statistically significant(P=0.036).The KSS scores and functional scores of the two prostheses were significantly improved after operation compared with those before operation(P<0.001).Although the KSS score and function score of Sled prosthesis after UKA were higher than those of Oxford prosthesis,there was no significant difference between them(P>0.05).Conclusion Both fixed platform UKA and active platform UKA have good clinical and imaging results,and there is no significant difference in short-term efficacy between them.

关 键 词：膝 内侧骨关节炎 单髁置换术 固定平台 活动平台 

分 类 号：R687.4[医药卫生—骨科学]