| 程宇翔,陈歌,陈建,等.膝骨关节炎单髁置换术后下肢冠状位力线对早期临床效果的影响.骨科,2022,13(3): 198-203,211. |
| 膝骨关节炎单髁置换术后下肢冠状位力线对早期临床效果的影响 |
| Influence of Postoperative Coronal Alignment on Early Clinical Efficacy after Unicompartmental Knee Arthroplasty for Knee Osteoarthritis |
| 投稿时间：2022-01-20 |
| DOI：10.3969/j.issn.1674-8573.2022.03.002 |
| 中文关键词: 单髁关节置换术 术后力线 膝骨关节炎 |
| 英文关键词: Unicompartmental knee arthroplasty Residual alignment deformity Knee osteoarthritis |
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| 中文摘要: |
| 目的 探讨单髁置换术（unicompartmental knee arthroplasty，UKA）后不同的下肢冠状位力线对早期临床效果的影响。方法 2018年8月至2019年6月，对93例（102膝）UKA术后病人进行回顾性分析，根据术后下肢力线将102膝分为三组，轻度内翻组（0°~3°）36膝、中等内翻组（3°~6°）37膝和重度内翻组（6°以上）29膝。比较三组术前及末次随访时的西安大略和麦克马斯特大学（the Western Ontario and McMaster Universities，WOMAC）骨关节炎指数及膝关节功能活动度，评估病人术后满意度。结果 随访24~34个月，平均27.1个月。末次随访时各组WOMAC评分以及轻度内翻组、中等内翻组的活动度均显著优于术前，差异有统计学意义（P＜0.05）。轻度内翻组、中等内翻组末次随访的活动度值均显著优于重度内翻组，差异有统计学意义（P＜0.05），但轻度内翻组和中度内翻组比较，差异无统计学意义（P＞0.05）。中度内翻组中有更多的病人（70%）认为非常满意（P=0.028）。结论 UKA术中将力线调整至内翻0°~6°均可获得不错的膝关节功能评分及活动度，但UKA术后力线在3°~6°范围内的病人较0°~3°组可有更好的早期满意度。 |
| 英文摘要: |
| Objective To investigate the influence of postoperative coronal alignment on early clinical efficacy after unicompartmental knee arthroplasty (UKA). Methods From August 2018 to June 2019, 93 patients (102 knees) receiving UKA in our hospital were retrospectively analyzed. The 102 knees were divided into the mild varus group (0°-3°) with 36 knees, the moderate varus group (3°-6°) with 37 knees, the severe varus group (above 6°) with 29 knees according to the postoperative lower limb coronal alignment. The Western Ontario and McMaster Universities (WOMAC) Arthritis Index and range of motion (ROM) preoperation and at last follow-up were compared, and we recorded the surgical satisfaction. Results The 93 patients were followed up for 24-34 months, with an average of 27.1 months. WOMAC score of the three groups and ROM of mild varus group and moderate varus group at the last follow-up were better than those before surgery with the difference being statistically significant (P＜0.05). The average ROM of knee joint in mild varus group and moderate varus group was greater than that of severe varus group respectively (P＜0.05), but there was no statistically significant difference in ROM between mild varus group and moderate varus group (P＞0.05). More patients in moderate varus group (70%) were very satisfied (P=0.028). Conclusion High knee score and great ROM can be obtained by adjusting the intraoperative coronal alignment to 0°-6°, and patients with HKA at 3°-6° after UKA had better early satisfaction than those with HKA at 0°-3°. |
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