单髁关节置换治疗前内侧间室膝骨关节炎中期效果观察  

Mid term effect of unicompartmental knee arthroplasty in the treatment of anterior medial compartment knee osteoarthritis

作　　者：赵秀泉[1] 季海龙[1] 胡学良 Zhao Xiuquan;Ji Hailong;Hu Xueliang(Fourth Department of Orthopedics,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061000,China)

机构地区：[1]沧州中西医结合医院东院区骨四科,061000

出　　处：《中华保健医学杂志》2023年第1期91-93,共3页Chinese Journal of Health Care and Medicine

基　　金：河北省沧州市重点研发项目(204106059)。

摘　　要：目的分析单髁关节置换(unicompartmental knee arthroplasty,UKA)治疗前内侧间室膝骨关节炎的中期效果,探讨手术适应证。方法 回顾性分析2015年10月~2020年3月沧州中西医结合医院因膝关节内侧间室骨性关节炎行膝关节单踝置换术患者83例(84膝),男37例,女46例,年龄44~87岁,体质量指数(BMI)23~33 kg/m^(2)。患者均使用Oxford第3代人工假体,采用微创入路完成UKA手术。术后随访2.1~6.5年,平均3.9年。使用美国膝关节协会评分(KSS)、西安大略和麦克马斯特大学骨关节炎评分(WOMAC)评估患者膝关节功能。测量膝关节活动度(ROM),记录术后并发症发生情况、计算假体生存率。结果 至末次随访,患者膝关节KSS评分和ROM均显著高于术前,WOMAC评分低于术前,差异均有显著统计学意义(P <0.05)。所有患者均未出现假体位置不良、假体松动下沉、假体周围骨溶解及需要行翻修的患者。2例出现衬垫脱位,1例屈膝手法挤压后复位,1例切开复位后更换加厚衬垫。假体生存率为97.59%(2/83)。结论 单髁置换治疗前内侧间室膝骨关节炎中期效果肯定,假体生存率高,阻止了关节炎向其他间室发展。虽然本组肥胖、年轻、合并膝前痛甚至髌股关节退变患者获得了良好效果,但对于手术指征具体如何放宽,还需要进一步进行大样本量对照研究。Objective To analyze the medium-term effect of unilateral knee arthroplasty(UKA)in the treatment of anterior medial compartment knee osteoarthritis,and to explore the surgical indications.Methods From October 2015 to March 2020,the data of patients who underwent knee arthroplasty due to medial compartment osteoarthritis of the knee were retrospectively analyzed.83 patients(84 knees)were included in the study,including 37 males and 46 females,aged 44-87 years,with a BMI of 23-33kg/m^(2).All patients used the third generation of Oxford artificial prosthesis and completed the UKA operation through the minimally invasive approach.Postoperative follow-up ranged from 2.1 to 6.5 years,with an average of 3.9 years.Patients'knee function was assessed using the American Knee association score(KSS),Western Ontario and McMaster University Osteoarthritis score(WOMAC).The ROM of knee joint was measured,the postoperative complications were recorded,and the survival rate of prosthesis was calculated.Results Up to the last follow-up,the KSS score and ROM of the patients'knee joint were significantly higher than that before operation,and the WOMAC score was lower than that before operation.The difference was statistically significant(P<0.05).There were no patients with poor position of the prosthesis,loosening and sinking of the prosthesis,osteolysis around the prosthesis and patients requiring revision.2 cases had pad dislocation,1 case was reduced after pressing with knee flexion manipulation,and 1 case was replaced with thickened pad after open reduction.The survival rate of prosthesis was 97.59%(2/83).Conclusion The mid-term effect of unicompartmental knee arthroplasty in the treatment of anterior medial compartment knee osteoarthritis is positive,the survival rate of prosthesis is high,and it prevents the development of arthritis to other compartments.Although the patients with obesity,youth,combined with anterior knee pain and even patellofemoral degeneration have achieved good results through accurate surgical operation,fur

关 键 词：内侧间室 膝骨关节炎 单髁关节置 中期疗效 手术指征 

分 类 号：R68[医药卫生—骨科学]