胫骨骨量保留技术在内侧固定平台单髁膝关节置换术中应用的短期临床疗效分析  

Short-term clinical efficacy analysis of tibial bone mass preservation technique used in medial fixed platform unicondylar knee arthroplasty

作　　者：黄威[1] 刘洋[1] 李文伟 魏明 沈先月 张林林 朱晨[1] HUANG Wei;LIU Yang;LI Wenwei;WEI Ming;SHEN Xianyue;ZHANG Linlin;ZHU Chen(Department of Joint Surgery,First Affiliated Hospital,University of Science and Technology of China/Anhui Provincial Hospital,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院/安徽省立医院关节外科,合肥230001

出　　处：《重庆医学》2025年第2期319-323,共5页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82472503);安徽省重点研究与开发计划基金项目(2023s07020008)。

摘　　要：目的 介绍胫骨骨量保留技术在内侧单髁膝关节置换术(MUKA)中的应用场景、操作步骤及初步临床效果。方法 选取2022年5月至2023年5月于该院治疗的15例前内侧膝骨关节炎(AMOA)患者为研究对象,采用胫骨骨量保留技术完成MUKA(固定平台假体),记录手术时间、术中出血量、住院时间、手术并发症;记录术前及末次随访时的膝关节视觉模拟量表(VAS)评分、膝关节关节活动度(ROM)、美国膝关节协会评分(KSS)、术侧下肢髋-膝-踝角(HKA)及影像结果以评价临床疗效。结果 15例患者均顺利完成手术。平均手术时间(82.73±9.97)min,平均术中出血量(21.00±9.49)mL,平均住院时间(4.9±1.4)d,术中无神经、血管、内侧副韧带损伤、医源性骨折,术后无手术部位感染。所有患者平均随访(5.87±2.77)个月。末次随访时,膝关节VAS评分、ROM、KSS、术侧下肢HKA均较术前明显改善(P<0.05)。影像检查未见假体松动、移位或碎裂,外侧间室均无明显退变加重。结论 胫骨骨量保留技术是应对MUKA手术过程中胫骨内侧平台截骨完成后屈曲间隙略紧的简便、有效且可靠的处理方法,术后临床疗效及影像学结果优良。Objective To introduce the application scene,operating steps and preliminary clinical effect of tibial bone mass preservation technique in medial unicompartmental knee arthroplasty(MUKA).Methods A total of 15 patients with antero-medial knee osteoarthritis(AMOA)treated in this hospital from May 2022 to May 2023 were selected as the study subjects.The tibial bone mass preservation technique was adopted to complete MUKA(fixed platform prosthesis).The operating time,intraoperative bleeding volume,hospitalization duration and operation complications were recorded.The VAS score before operation and in last follow up,range of motion(ROM)of knee joint,Knee Society Score(KSS),hip and knee stomping angle(HKA)of lower extremity in the operation side and image results were recorded to evaluate the clinical effect.Results The operations in 15 cases were successfully completed.The average operation time was(82.73±9.97)min,mean intraoperative bleeding volume was(21.00±9.49)mL and average hospital stay was(4.9±1.4)d.There was no intraoperative nerve,vascular and medial collateral ligament injury,no iatrogenic fracture,and no postoperative surgical site infection.All patients were followed up for average(5.87±2.77)months.The VAS score of knee joint,ROM,KSS and HKA angle of lower limb in the operated side were significantly improved compared with before operation(P<0.05).There was no prosthesis loosening,displacement or fragmentation,and no obvious degeneration aggravation of the lateral compartment of the knee joint.Conclusion The tibial bone mass preservation technique is a simple,effective and reliable method to deal with the slightly tight flexion space after tibial osteotomy during MUKA,and the postoperative clinical efficacy and imaging results are excellent.

关 键 词：胫骨骨量保留技术 固定平台假体 前内侧膝骨关节炎 单髁置换术 

分 类 号：R687.4[医药卫生—骨科学]