| 翟凯,王冰,周珂,等.胫骨平台后倾角变化对单髁关节置换术后关节功能及假体生存率的影响.骨科,2024,15(1): 18-23. |
| 胫骨平台后倾角变化对单髁关节置换术后关节功能及假体生存率的影响 |
| Effect of Posterior Tibial Slope Change on Joint Function and Prosthesis Survival Rate after Unicompartmental Knee Arthroplasty |
| 投稿时间：2023-09-28 |
| DOI：10.3969/j.issn.1674-8573.2024.01.004 |
| 中文关键词: 单髁膝关节置换 胫骨平台后倾角 膝关节功能 假体生存率 |
| 英文关键词: Unicompartmental knee arthroplasty Posterior tibial slope Knee joint function Prosthesis survival rate |
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| 中文摘要: |
| 目的 探讨第3代Oxford假体单髁膝关节置换术（unicompartmental knee arthroplasty，UKA）后胫骨平台后倾角（posterior tibial slope，PTS）变化对膝关节功能及假体生存率的影响。方法 回顾性分析我院自2017年1月至2021年8月收治的194例（206膝）行内侧单髁膝关节置换术的病人，根据术前及术后后倾角变化差值进行分组：A组60例（63膝），后倾角增大＞2°；B组101例（108膝），后倾角变化≤2°；C组33例（35膝），后倾角减小＞2°。采用美国特种外科医院（HSS）评分、牛津大学膝关节评分（OKS）及患膝关节屈伸活动度（ROM）评估膝关节功能。统计206膝术后并发症情况并采用Kaplan-Meier法评估假体生存率。结果 三组术后均获得良好的膝关节功能。术前三组间HSS评分、OKS评分及ROM的差异无统计学意义（P＞0.05）；末次随访时三组间HSS、OKS评分差异有统计学意义（P＜0.05），其中B组HSS评分高于A、C两组，OKS评分低于A、C两组，而三组间ROM差异无统计学意义（P＞0.05）。共7例（7膝）出现并发症，其中A组1例，为聚乙烯衬垫脱位；B组3例，分别为内侧胫骨平台塌陷、聚乙烯衬垫脱位、胫骨平台假体松动；C组3例，分别为外侧间室骨性关节炎进展、胫骨平台假体松动、聚乙烯衬垫脱位。三组并发症发生率：C组（8.57%）＞B组（2.78%）＞A组（1.59%），206膝假体生存率为96.6%。结论 对于术后胫骨假体后倾角的选择要个体化、精准化，手术前后胫骨平台后倾角变化≤2°可使病人获得更好的膝关节功能及临床疗效。 |
| 英文摘要: |
| Objective To investigate the influence of posterior tibial slope (PST) changes on knee function and prosthesis survival after 3rd generation Oxford unicompartmental knee arthroplasty (UKA). Methods The clinical data of 194 patients (206 knees) admitted to our institution for medial UKA from January 2017 to August 2021 were retrospectively analyzed. The groups were divided according to the the difference in preoperative and postoperative changes in PTS: 60 cases (63 knees) with PTS increased ＞2° in group A, 101 cases (108 knees) with PTS changed ≤2° in Group B, 33 cases (35 knees) with PTS decreased ＞2° in group C. The knee joint function was evaluated using the Hospital for Special Surgery (HSS) score, Oxford Oxford knee score (OKS) and the range of motion (ROM). The postoperative complications of 206 knees were analyzed and the Kaplan-Meier method was used to evaluate the prosthesis survival rate. Results All three groups achieved good knee joint function after surgery. There was no significant difference in HSS, OKS and ROM among the three groups before surgery (P＞0.05). At the last follow-up, there was a significant difference in HSS and OKS among the three groups (P＜0.05). The HSS in the group B was higher than that in the groups A and C, while the OKS score was lower in the group B than in the groups A and C. However, there was no statistically significant difference in ROM among the three groups (P＞0.05). A total of 7 complications occurred in 206 knees, including one case in group A (a dislocation of polyethylene liner), 3 cases in group B (medial tibial plateau collapse, polyethylene pad dislocation, and tibial plateau prosthesis loosening), 3 cases in group C (progression of lateral compartment osteoarthritis, loosening of tibial plateau prosthesis, and dislocation of polyethylene pad). The incidence of complication was 8.57% in group C ＞ 2.78% in group B ＞ 1.59% in group A. The survival rate of the 206 knee prosthesis was 96.6%. Conclusion The choice of the postoperative PTS must be individualized and precise. The PTS change of ≤2° before and after surgery can enable patients to achieve better knee joint function and clinical efficacy. |
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