内翻畸形膝骨关节炎软骨磨损的临床研究

Wear patterns of articular cartilage in varus knee osteoarthritis

[目的]研究内翻畸形膝骨关节炎关节软骨磨损病变特点,探讨关节软骨磨损模式,分析全膝关节置换病例潜在符合Oxford单髁关节置换术的比例。[方法]回顾性分析本院2012年3~9月收治的73膝全膝关节置换术治疗的内翻畸形膝骨关节炎患者的临床资料,对截骨标本进行分析,分析软骨磨损特点。根据Oxford单髁关节置换病例选择标准,分析符合标准的患者比例。[结果]患者平均年龄(67.72±7.05)岁,平均内翻(7.51±4.45)°。内侧胫骨平台磨损最多见于中间1/3关节面,其次是前中部2/3关节面,分别占30.1%、28.8%。内侧间室股骨磨损最多见于中间关节面,占43.1%。外侧间室软骨磨损率为16.4%,其中外侧间室股骨软骨退变比例仅占9.6%,胫骨平台软骨退变比例占16.4%。内侧间室软骨磨损最严重处的软骨平均厚度分别为(0.73±1.11)mm(胫骨)、(0.61±0.91)mm(股骨)。外侧间室胫骨软骨平均厚度为(3.07±0.97)mm,股骨平均厚度为(2.93±0.75)mm。前交叉韧带缺失或功能不全的比例为12.3%。根据Oxford单髁关节置换病例选择标准,结果有19.2%符合此标准。[结论]在膝关节骨性关节炎,内侧间室股骨和胫骨关节面的中间1/3最常累及,其次是前中部2/3关节面。外侧间室软骨磨损比例占16.4%。19.2%符合Oxford单髁关节置换指证。

[Objective] To analyze the gross features of articular cartilage erosion in varus knee osteoarthritis,and discuss the particular pattern,together with their frequency of eligibility criteria for unicompartmental knee arthroplasty.[Methods]Data collected from the dissection of 73 knees total knee arthropalsty with varus knee osteoarthritis from March 2012 to Septembe r2012 were analyzed.[Results] The mean age was(67.72±7.05) years,varus degree was(7.51±4.45) °.Wear patterns on the meidal compartmental surface showed that the areas involved in the majority of cases included middle(30.1%) and anterio- middle regions(28.8%).The wear incidence of lateral compartmental was 16.4%.The incidence of ACL- deficiency was 12.3%.19.2% cases would likely to be indicated for unicompartmental knee replacement.[Conclusion] In varus knee osteoarthritis,the middle third of both the femoral and tibial articular surfaces is most commonly involved.The wear incidence of lateral compartmental was only 16.4%.It is potential to utilize UKA more frequently in the future.