人工单髁置换术治疗膝关节内侧间室骨关节炎合并前交叉韧带功能不良的近期疗效  

Short-term efficacy of unicondylar replacement in treatment of medial compartment arthritis of the knee combined with anterior cruciate ligament dysfunction

作　　者：于晓光[1] 秦永辉 李佳 贾国兴 李军[1] 赵振栓 刘国彬[1] Yu Xiaoguang;Qin Yonghui;Li Jia;Jia Guoxing;Li Jun;Zhao Zhenshuan;Liu Guobin(Department of Orthopedic Surgery,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院膝关节外二科,石家庄050031

出　　处：《中华临床医师杂志（电子版）》2024年第4期337-342,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：2022年度河北省医学科学研究课题计划(编号:20221373)。

摘　　要：目的探讨膝内侧间室骨关节炎合并前交叉韧带功能不良患者人工单髁关节置换术后效果及预后。方法回顾性分析2019年1月至2021年1月进行在河北医科大学第一医院骨科诊断为膝关节内侧间室关节炎合并前交叉韧带功能不良并行内侧活动平台单髁置换术治疗的患者87例,通过测量并分析胫骨后倾角、膝关节的伸屈活动范围、膝关节损伤和骨关节炎评分及并发症的发生情况以评估患者手术效果及预后。结果本研究纳入的87例患者的胫骨后倾角较术前显著降低(P<0.05),膝关节活动度较术前显著改善(P<0.05)。KOOS疼痛评分(KOOS Pain),KOOS症状评分(KOOS Symptom),KOOS日常活动评分(KOOS Activities of Daily Living),KOOS运动评分(KOOS Sport)和KOOS生活质量评分(KOOS Quality of Life)评分较术前均有所上升,除KOOS症状评分(KOOS Symptom),其余各项评分随访期较术前显著升高(P<0.05)。在两年的随访过程中,无一例需要进行翻修,没有发现假体松动、位置不良、脱位,也没有出现感染、脂肪栓塞或深静脉血栓等并发症。所有患者术后膝关节功能良好,提高了生活质量以及改善了精神状态。结论通过严格把握适应征以及对前交叉韧带功能不良患者进行详细的评估后,可行人工单髁关节置换术使其减轻疼痛、改善生活质量及获得良好的预后。Objective To investigate the outcome and prognosis after unicondylar knee replacement in patients with medial interphalangeal arthritis of the knee combined with anterior cruciate ligament dysfunction.Methods Eighty-seven patients diagnosed with medial interphalangeal arthritis of the knee combined with anterior cruciate ligament dysfunction and treated with medial mobility platform unicondylar replacement at the Department of Orthopaedics,the First Hospital of Hebei Medical University were retrospectively analyzed from January 2019 to January 2021,and the surgical results and prognosis of the patients were assessed by measuring and analyzing the posterior tilt angle of the tibia,the range of knee extensor/flexor motion,the scores of knee injuries and osteoarthritis,and the occurrence of complications.Results In the 87 patients included in this study,tibial lordosis was significantly reduced(P<0.05)and knee mobility was significantly improved(P<0.05)compared with those before operation.The scores of pain,symptom,activities of daily living,sport,and KOOS quality of life dimensions of the knee injury and osteoarthritis outcome score(KOOS)were all increased compared with the scores before operation;all these scores,except KOOS symptom score,were significantly higher during the follow-up period compared to those in the preoperative period(P<0.05).During the two-year follow-up,none of the cases required revision,and no loosening,malpositioning,or dislocation of the prosthesis were reported,nor were the complications such as infection,fat embolism,or deep vein thrombosis.All patients had good postoperative knee function and improved quality of life as well as mental status.Conclusion Unicondylar knee arthroplasty is feasible to reduce pain,improve quality of life,and achieve a good prognosis for patients with anterior cruciate ligament dysfunction after strict control of indications and detailed evaluation.

关 键 词：膝关节骨性关节炎 前交叉韧带 单髁关节置换术 

分 类 号：R687.4[医药卫生—骨科学]