| 郑守超,石晶,王峰,等.固定平台单髁置换术治疗膝关节前内侧骨关节炎的早期临床疗效.骨科,2021,12(1): 34-39. |
| 固定平台单髁置换术治疗膝关节前内侧骨关节炎的早期临床疗效 |
| Early clinical effectiveness of fixed bearing unicompartmental knee arthroplasty for knee anteromedial osteoarthritis |
| 投稿时间：2020-03-21 |
| DOI：10.3969/j.issn.1674-8573.2021.01.007 |
| 中文关键词: 微创小切口 固定平台 单髁置换术 前内侧膝骨关节炎 |
| 英文关键词: Invasive incision Fixed bearing Unicompartmental knee arthroplasty Anteromedial osteoarthritis |
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| 中文摘要: |
| 目的 探讨微创小切口固定平台单髁置换术治疗膝关节前内侧骨关节炎的早期临床疗效。方法 回顾性分析2018年5月至2019年10月在我科行小切口固定平台内侧单髁置换术的40例病人（43膝）的临床资料，其中男19例（20膝），女21例（23膝），年龄为（63.3±5.23）岁（53~79岁）。记录并分析病人手术时间、出血量、下地时间和并发症，术前和末次随访时病人的膝关节疼痛视觉模拟量表（visual analogue scale，VAS）评分、美国膝关节协会评分（Knee Society Score，KSS）、牛津大学膝关节评分（Oxford Knee Score，OKS）、膝关节最大活动度（range of motion，ROM）、髋-膝-踝角（hip-knee-ankle angle，HKA）等。结果 病人手术时间为（79.14±5.44） min，出血量为（85.12±10.32） mL，下地时间为（9.65±5.36） h。病人均获得随访，随访时间平均为10.2个月。术后VAS、KSS和OKS评分均较术前明显改善（P均＜0.05）；术后膝关节ROM较术前明显改善且差异有统计学意义（t=-13.788，P＜0.001）；影像学测量HKA显示术后膝关节内翻均得到不同程度矫正。术中股骨髁骨折1例、术后膝关节外翻1例，无感染、假体松动、僵硬等病例。结论 微创小切口固定平台单髁置换术早期显著改善膝关节功能，并具有创伤小、保留膝关节韧带、康复快等优势，是治疗膝关节前内侧骨关节炎的有效方法。 |
| 英文摘要: |
| Objective To investigate the early clinical effectiveness of fixed bearing unicompartmental knee arthroplasty (UKA) with invasive incision for knee anteromedial osteoarthritis. Methods The clinical data of 40 patients (43 knees) undergoing fixed bearing UKA with invasive incision in our department from May 2018 to October 2019 were retrospectively analyzed, including 19 males (20 knees) and 21 females (23 knees), aged (63.3±5.23) years (53-79 years). The operation time, bleeding loss, ambulation time and complications were recorded and analyzed. The curative effectiveness was evaluated by visual analogue scale (VAS), Knee Society Score (KSS), Oxford Knee Score (OKS), range of motion (ROM), and hip-knee-ankle angle (HKA). Results The operation time was (79.14±5.44) min, the blood loss was (85.12±10.32) mL, and the ambulation time was (9.65±5.36) h. All patients were followed up for an average of 10.2 months. The scores of VAS, KSS and OKS were significantly improved after operation (P＜0.05), and the ROM of knee joint was significantly improved after operation (t=-13.788, P＜0.001). The HKA angle was partially corrected. At the end point of follow-up, complications occurred in 2 cases, including one case of femur medial condyle fracture during operation and one case of overcorrected axis. No infection, prosthesis loosening and stiffness occurred. Conclusion Fixed bearing UKA has advantages of less invasive incision, preserving knee ligaments and enhanced recovery. Fixed bearing UKA could significantly improve knee function in early stage, which is a effective treatment for knee anteromedial osteoarthritis. |
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