摘要
目的 比较活动与固定平台的单髁假体置换术治疗膝关节内侧间室骨关节炎的短期疗效,并探讨单髁置换术的手术指征、假体选择及手术技术.方法 回顾性分析2010年3月至2013年6月收治43例（45膝）膝关节内侧间室骨关节炎患者资料.其中17膝采用活动平台假体,男7例（7膝）,女9例（10膝）;年龄54～82岁,平均64.1岁.28膝采用固定平台假体,男10例（10膝）,女17例（18膝）,年龄43～79岁,平均62.2岁.所有患者均有关节内侧间室狭窄、内侧压痛和负重时疼痛.术后比较两组患者膝关节疼痛、关节活动度、关节力线、美国膝关节协会评分（Knee Society Score,KSS）等,其中2例行前十字韧带重建的患者同时行Tegner-Lysholm膝关节评分.结果 术后患者均获得随访,随访时间6～37个月,平均21.1个月,随访期间无一例发生深静脉血栓、假体松动移位、脱位等并发症.活动平台组KSS评分术前为（56.11±9.51）分,术后为（92.23±5.46）分;术前与术后比较,差异有统计学意义.固定平台组KSS评分术前为（57.11±9.56）分,术后为（93.69±6.37）分;术前与术后比较,差异有统计学意义.活动平台组和固定平台组KSS评分比较,差异无统计学意义.结论 单髁置换治疗膝关节内侧间室骨关节炎临床疗效满意,创伤小,并发症少,在术后的短期随访中活动平台与固定平台假体之间临床疗效无明显差别.
Objective To study the short-term clinical outcomes of unicompartmental knee arthroplasty for medial compartmental knee osteoarthritis,and to compare 2 kinds of unicompartmental prosthesis.Methods From March 2010 to June 2013,data of 43 patients underwent unicompartmental knee arthroplasty （UKA） were retrospectively analyzed.17 patients （17knees） used rotating platform prosthesis,and 26 patients （28 knees） used fixed bearing prosthesis.There were 7 males （7 knees）and 9 females （10 knees） in rotating platform group,with an average age of 64.1 years （range,54-82 years）;while 10 males （10knees） and 17 females （18 knees） in fixed bearing group,with an average age of 62.2 years （range,43-79 years）.All patients presented signs of narrowed medial joint space,medial tenderness and pain on weight-bearing.X-ray and MRI were used for documenting joint narrowing and cartilage defect.The pain and the knee functions were recorded both pre and post-operatively with knee society score （KSS）,2 cases of simultaneous anterior cruciate ligament （ACL） reconstruction were assessed with TegnerLysholm knee scoring scale as well.Results All 43 patients were followed up for 6 month to 37 months,and the average duration was 21.1 months.There were no dislocations,joint infection,deep venous thrombosis,prosthetic loosening,etc.The KSS in rotating platform group was 56.11 ±9.51 preoperatively,and 92.23±5.46 postoperatively.While the KSS in fixed bearing group was 57.11 ±9.56,and 93.69±6.37,respectively.There were statistical differences comparing between preoperative and postoperative KSS knee scores.There was no significant difference in KSS scores between rotating platform group and fixed bearing group.Conclusion Unicompartmental knee arthroplasty is a less invasive and effective method for knee osteoarthritis in medial compartment with less complications.There was no significant difference in clinical outcomes between rotating platform and fixed bearing design in terms of patients＇ satisfac
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2015年第7期691-698,共8页
Chinese Journal of Orthopaedics
关键词
膝关节
骨关节炎
关节成形术
置换
膝
Knee joint
Osteoarthritis
Arthroplasty,replacement,knee
