摘要
背景：目前单髁关节置换术（unicompartmental knee arthroplasty,UKA）后外侧间室采用X线评估存在局限性,且关节置换MRI应用存在认识误区,国内尚无单髁关节置换术后进行MRI扫描的研究。目的目的：探讨Oxford单髁关节置换术后应用MRI检查评估外侧间室的安全性及临床价值。方法方法：选取15例Oxford内侧UKA术后随访患者,分别行膝关节MRI常规序列扫描,其中男3例,女12例,左9例,右6例,年龄56-75岁,术后随访6个月至5年,关节活动度118°-130°,HSS评分78-98分。两位观察者独立阅片评估外侧间室、外侧半月板、外侧副韧带、前后交叉韧带等结构能见度。MRI检查后一小时留院内观察不良反应。结果结果：所有患者在MRI扫描操作期间及随后一小时均无不良反应。外侧间室软骨可清晰显示比例95.6%、外侧半月板清晰显示100%、外侧副韧带清晰显示94.4%。所有患者内侧间室、前后交叉韧带及内侧副韧带均不可见。髌股间室清晰显示92.2%,髌韧带清晰显示88.9%、髌下脂肪垫88.9%。9例患者（60%）于MRI中发现关节积液。伪影干扰影响外侧间室范围5%-20%。结论结论：Oxford单髁关节置换术后应用MRI检查是安全的,可获得满意的外侧间室结构显示。
Background： X ray has a limitation in the evaluation of residual lateral knee unicompartment after Oxford unicompartmental knee arthroplasty（UKA）. However,MR imaging of the replaced knee has been mistaken and not used in the evaluation until now. Objective： To clarify the safety and value of MRI after Oxford UKA for residual lateral knee unicompartment. Methods： Fifteen UKA patients were studied with 1.5-T MRI. There were 3 males and 12 females aged from 56 to75 years old. The involved knee was on the left in 9 patients and on the right in 6 patients. Two researchers independently evaluated the residual anatomical items with the visibility for each sequence： lateral knee unicompartment,lateral meniscus,lateral collateral ligament,anterior cruciate ligament,posterior cruciate ligament,medial knee unicompartment,medial collateral ligament,femoral-patellar unicompartment,and patellar ligament. All patients were asked to remain in our department for about one hour after the examination to assess any adverse event. Results： No adverse effect was reported during or within 1 hour after the examination. Medial knee unicompartment,anteo-posterior cruciate ligament and medial collateral ligament were unseen in all patients by both observers. The percentage visibility of lateral knee unicompartment was 95.6%,lateral meniscus was 100%,and lateral collateral ligament was 94.4%. The patellofemoral compartment was clearly displayed in 92.2% of the patients,the patellar ligament was clearly shown in 88.9%,and the patellar fat pad was in 88.9%.Joint fluid was shown in 9 knees. The artifact on MRI influenced 5%-20% of the lateral knee unicompartment. Conclusions：MRI after UKA offers a safe and reproducible method to evaluate the residual lateral knee unicompartment.
出处
《中国骨与关节外科》
2016年第6期468-471,共4页
Chinese Journal of Bone and Joint Surgery
基金
卫生部中日友好医院青年课题(2013-QN-28)
首都卫生发展科研专项(2016-2-4062)
关键词
单髁关节置换术
膝关节骨关节炎
外侧间室
MRI
Unicompartmental Knee Arthroplasty
Knee Osteoarthritis
Lateral Knee Unicompartment
MRI
