再议膝关节单髁置换术的适应证

Reconsideration of the indications for unicompartmental knee arthroplasty

膝关节单髁置换术(UKA)作为近年来逐渐兴起的一种术式,由于其显著的临床优势,被认为是解决膝关节疼痛及恢复良好功能的有效方法。20世纪80年代Kozinn和Scott等代表提出的经典适应证长期以来一直作为UKA的选择标准。然而,随着治疗理念、手术器械、手术技术和假体设计的改进,这些30多年前提出的适应证显得过于局限,导致UKA的推广应用受到一定限制。具体来说,外科医生对基于肥胖、年龄、髌股关节炎、严重膝内翻畸形、前交叉韧带功能缺失、屈曲挛缩、胫骨高位截骨术后失败和创伤后关节炎等问题提出了新的观点。为此,本文将根据目前的证据简要论述涉及UKA适应证的现代观点,以期为读者提供一些参考。

Unicompartmental knee arthroplasty(UKA),a procedure that has gradually emerged in recent years,is considered an effective treatment for resolving knee pain and restoring good function due to its significant clinical advantages.In the 1980s,Kozinn and Scott proposed the classic indications as selection criteria to identify ideal candidates for UKA.However,as treatment concepts,surgical instruments,surgical techniques,and prosthesis designs for this disease have improved,these indications proposed more than 30 years ago appear too limited,leading to some limitations in the widespread use of UKA.Specifically,surgeons have offered new perspectives on issues related to obesity,age,patellofemoral arthritis,severe varus deformity of the knee,anterior cruciate ligament deficiency,flexion contracture,failed high tibial osteotomy and post-traumatic arthritis.For this reason,this article will briefly discuss modern perspectives involving the indications for UKA based on current evidence with the aim of providing a reference for the reader.