人工单髁置换治疗膝单间室严重骨关节炎

Unicompartmental knee arthroplasty for severe osteoarthritis of knee in single compartment

目的观察人工单髁置换（UKA）治疗膝关节单间室严重骨关节炎的疗效。方法对52例（60膝）骨性关节炎患者行UKA。术前关节镜检查，采用微创小切口技术和Sled、M-G假体。结果8例（8膝）因关节镜下髌骨关节面软骨损伤严重，改行关节镜清理或全膝置换术。44例（52膝）获随访1～6年。Bristol评分较术前均有升高，术前为21．93分，术后1个月达36．98分，6个月达48．12分。40例（46膝）患者术后1年胫骨假体周围出现约2mm透光带，此后未再进一步发展，患膝无症状。结论人工单髁置换治疗膝单间室严重骨关节炎是一种行之有效的方法，较全膝置换费用降低，创伤小，恢复快，功能好。

Objective To study the results of unicompartmental knee arthroplasty （UKA） for knee osteoarthritis with single compartment. Methods 52 patients （60 knees） were undergone arthroscopy and UKA by minimally invasive surgery （MIS） technique with Sled or M-G prosthesis. Results 44 patients（52 knees） were followed up for average 3.6 years （1 -6 years）. Bristol knee score and X-ray evaluation was done in 1st, 6th month after operation. 8 patients（ 8 knees） were performed debridement or total knee arthroplasty（TKA） because cartilage damage of patellofemoral joint was seen through arthroscopy. Bristol scores were improved from 21.93 preoperatively to 36.98 in 1 month, and 48.12 in 6 months postoperatively. Radiolucent lines of 2 mm was found under tibia prosthesis 1 year after operation in 40 patients （46 knees）, but was asymptomatic until the end of the follow-up. Conclusions UKA is an effective method for severe osteoarthritis of knee in single compartment. It requires lower cost, minimal trauma, and provides faster recovery and better function than TKA .