膝关节单髁置换术治疗单侧胫股间隙骨关节炎的临床研究

The clinical study of unicondylar knee arthroplasty for unicompartmental knee osteoarthritis

目的探讨膝关节单髁置换术治疗单室膝关节骨关节炎(OA)的方法和疗效。方法采用单髁置换术治疗26例内侧单室膝关节OA患者,平均年龄58岁(52～76岁)。临床均表现为膝关节内侧间隙疼痛,AhlbackX线分级Ⅰ～Ⅲ级。采用HISS评分系统评估术后膝关节的功能,观测膝关节的活动度,摄下肢全长X线片观察下肢的力线(髋膝踝角),观察其并发症。结果术前髋膝踝角为5～10°,术后2周为0～2°;术前屈曲挛缩0～10°,膝关节活动度为100～120°,术后屈曲挛缩0～4°,膝关节活动度为125～135°。术前HISS评分72分,术后2周为98分。26例均获得随访,平均随访时间8.2个月(5～14个月),无感染、假体位置不良及髌股关节疼痛等并发症。结论对于单室膝关节OA,单髁置换具有膝关节功能恢复快、并发症少、创伤小等优点。

Objective To study the method and curative effect of unicondylar knee arthroplasty for unicompartmental knee osteoarthritis. Methods Twenty-six patients with isolated medial compartmental osteoarthriris of the knee were treated with unicompartmentai knee anhroplasty. The average age of the patients was 58 years （ range, 52-76years）. The indications for surgery were pain in the isolated medial compartntent of the knee and stagesⅠ～Ⅲ by the Ahlback＇s radiological classification. Patients were evaluated by HISS knee score and line of force joint of the lower limbs and range of motion of knee. Results The postoperative average HISS hip score was 98 after 2 weeks versus preoperative 72. The postoperative hip-knee-ankle angle were 0 - 2° after 2 weeks against preoperative 5 - 10°. The postoperative flexion contraction angle were 0 -4° after 2 weeks against preoperative 0- 10% The postoperative joint range of motion of knee were 125 - 135° after 2 weeks against preoperative 100 - 120°. 26 knees were all followed up. The average follow-up period was 8.2 months. No infectionprothesis cacothesis and patellofemoral joint pain were found. Conclusions Our comparative study suggests unicondylar knee arthroplasty has less trauma, more rapid rehabilitation, less complication for isolated medial compartmental osteoarthritis.