活动与固定平台假体在单髁膝关节置换术治疗膝关节前内侧骨关节炎中的临床疗效及安全性比较  

Comparison of the efficacy and safety of activity and fixed platform prosthesis in uniarticular knee arthroplasty for anterolateral knee joint osteoarthritis

作　　者：侯江业 李耀章 张宁 杨振邦[1] HOU Jiang-ye;LI Yao-zhang;ZHANG Ning(Department of Orthopaedics,The First Hospital of Yulin,Yulin Shaanxi 719000,China)

机构地区：[1]榆林市第一医院骨科,陕西榆林719000

出　　处：《临床和实验医学杂志》2025年第3期288-292,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省科技发展计划项目(编号:2022-KK8744)。

摘　　要：目的比较活动与固定平台假体在单髁膝关节置换术(UKA)治疗膝关节前内侧骨关节炎中的临床疗效及安全性。方法回顾性选取2019年1月至2022年1月榆林市第一医院收治入院的64例膝关节前内侧骨关节炎患者,依据治疗方式分为活动组(n=32)与固定组(n=32)。两组患者均接受UKA治疗,其中活动组使用Oxford活动平台,固定组使用Link固定平台。观察两组患者术前、术后1个月的疼痛[视觉模拟评分法(VAS)]评分,术前、术后2年的美国膝关节协会评分法(KSS)评分、美国特种外科医院膝关节(HSS)评分、关节最大伸直角度、关节最大屈曲角度、胫骨平台后倾角(STA)、胫股角,并观察两组患者的术后并发症(关节炎进展、关节纤维化及出血、衬垫脱位、假体松动、感染)发生情况。结果(1)VAS评分。术后1个月,两组患者的VAS评分均较术前明显降低,差异均有统计学意义(P<0.05);两组患者术后1个月VAS评分比较,差异无统计学意义(P>0.05)。(2)KSS、HSS评分。术后2年,两组患者的KSS评分、HSS评分均较术前明显提高,差异均有统计学意义(P<0.05);两组患者术后KSS、HSS评分比较,差异均无统计学意义(P>0.05)。(3)关节活动度。术后2年,两组患者的关节最大伸直角度、STA、胫股角均较术前明显降低,关节最大屈曲角度均较术前明显增大,差异均有统计学意义(P<0.05);两组患者术后2年的STA、胫股角比较,差异均无统计学意义(P>0.05)。活动组患者术后2年的关节最大伸直角度为(1.25±0.51)°,低于固定组[(2.36±0.62)°],关节最大屈曲角度为(132.97±9.15)°,高于固定组[(128.34±9.06)°],差异均有统计学意义(P<0.05)。(4)并发症。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论UKA治疗膝关节前内侧骨关节炎中活动与固定平台假体均具有显著疗效和良好的安全性,但Oxford活动平台可进一步促进患者下肢力线快速恢复。Objective To compare the clinical efficacy and safety of activity and fixed platform prosthesis in uniarticular knee arthroplasty(UKA)for anterolateral knee joint osteoarthritis.Methods A total of 64 patients with anterolateral knee joint osteoarthritis admitted to The First Hospital of Yulin from January 2019 to January 2022 were retrospectively selected and divided into the activity group(n=32)and the fixed group(n=32)according to the different treatment methods.Both groups received UKA treatment,in which the Oxford activity platform was used in the activity group and the Link fixation platform was used in the fixed group.The pain[visual analogue scale(VAS)]scores of the two groups were observed before and 1 month after operation,the American Knee Society score(KSS)score,Hospital for Special Surgery(HSS)score,maximum extension angle of joint,maximum flexion angle of joint,sagittal tibial angle(STA)and tibiofemoral angle of the two groups were observed before and 2 years after operation.The postoperative complications(arthritis progression,joint fibrosis and bleeding,liner dislocation,prosthesis loosening and infection)of the two groups were observed.Results(1)VAS score.At 1 month after operation,the VAS scores of the two groups were significantly lower than those before operation,and the differences were statistically significant(P<0.05).There was no statistically significant difference in VAS score between the two groups at 1 month after operation(P>0.05).(2)KSS,HSS score.At 2 years after operation,the KSS score and HSS score of the two groups were significantly higher than those before operation,and the differences were statistically significant(P<0.05).There were no significantly significant difference in postoperative KSS and HSS score between the two groups at 2 years after operation(P>0.05).(3)Range of motion.At 2 years after operation,the maximum extension angle of the joint STA and tibiofemoral angle in the two groups were significantly lower than those before operation,and the maximum flexion angle of

关 键 词：膝关节前内侧骨关节炎 单髁膝关节置换术 固定平台 活动平台 临床疗效 安全性 

分 类 号：R687.4[医药卫生—骨科学]