膝关节单髁置换的疗效与评价研究

Clinical results of unicompartmental knee arthroplasty and specific assessment score

[目的]总结单髁置换术(UKA)治疗单间室膝骨性关节炎的中期疗效,探讨其疗效及评价方法。[方法]自2004年3月～2006年9月22例(22膝)单间室膝骨性关节炎患者行UKA,术后平均随访时间为34个月(14～49个月)。疗效评定选用HSS、KSS、WOMAC评分,于术前及随访时分别进行评定。同时提出《膝关节单髁置换术专用评分标准》(UKA专用评分)进行术后评定。[结果]术后22例患者患膝关节疼痛明显缓解,关节活动度改善,生活质量提高。HSS、KSS、WOMAC评分术前及随访时差异具有统计学意义(P<0.01)。随访时UKA专用评分平均87.2分,优15膝,良7膝,无可或差。UKA专用评分与HSS、KSS、WOMAC评分标准在同一患者得所结果紧密相关(r值分别为:0.892、0.921、0.914、-0.827)。[结论]UKA是治疗单间室膝骨性关节炎的有效方法,中近期效果满意。《膝关节单髁置换术专用评分标准》可综合评价UKA的术后疗效。

[ Objective] To summarize the middle-term results of unicompartment knee arthroplasty （UKA）, and postulate a new specific assessment score. [ Method ] From March 2004 to September 2006, unicompartment knee arthroplasty had been proformed in 22 patients （22 knees）with unicompartment osteoarthritis. The mean follow-up period was 34 months（ range from 14 to 49 months）. The HSS score,KSS score and WOMAC score were used to evaluate the outcomes of UKA at the time of preoperation and follow-up respectively. A new unicompartment knee arthroplasty specific score was postulated to evaluate the results of UKA. [ Result ] At the time of the final follow-up, pain relief was significant in all patients, and the range of motion and quality of living were improved. The HSS score, KSS score and WOMAC score were significantly improved compared with pre-operation （ P 〈 0.01 ）. The mean specific UKA score was 87.2. Fifteen knees rated as excellent and 7 as good. No fair or poor results were noted. The outcome of UKA score was closely correlated with that of the HSS score, KSS score and WOMAC score （ r =0. 892,0. 921,0. 914, -0.827 ）. [ Conclusion] Unieompartment knee arthroplasty is an effective procedure for unicompartmental knee osteoarthritis. The middle-teIm result of UKA is satisfactory. The unicompartment knee arthroplasty specific score can be used to comprehensively evaluate the curative effect of UKA.