膝关节单髁置换的近期疗效观察

The efficacy of unicompartment knee arthroplasty for knee joint disease

目的了解膝关节单髁置换(unicompartment knee arthroplasty,UKA)治疗膝关节病变的近期疗效,探讨其手术适应证及手术要点。方法 2006年3月至2009年1月行UKA治疗44例膝关节病变患者,其中男6例6膝,女38例39膝;年龄53～66岁,平均58.7岁;内侧髁置换36例37膝,外侧髁置换8例8膝。术前行膝关节伸直位正侧位X线片及MR检查,测量术前及术后胫股角(femorotibialangle,FTA)、膝关节主动活动度,并进行膝关节评分(hospital for special surgery knee score,简称HSS评分)。结果全部获得随访,随访时间为12～48个月,平均26个月。术后FTA与术前相比,差异有统计学意义(P<0.005);随访屈曲度与术前相比,差异有统计学意义(P<0.025;P<0.05);术后HSS评分与术前相比,差异有统计学意义(P<0.001)。结论 UKA具有创伤小、术后功能恢复良好的优点,但手术指征不统一,术中技术要求高,中远期疗效有待于进一步随访。

Objective To report the short-term efficacy of unicompartment knee arthroplasty（UKA） for knee disease, and to discuss the indications and surgical pitfalls.Methods From March 2006 to January 2009,44 patients underwent UKA.Of them,there were 6 males（6 knees） and 38 females（39 knees） with an average age of 58.7 years.Before the operation,Xray and MRI were used for each knee joint examination.Femorotibialangle（FTA） and the range of motion were measured and pre-operative and post-operative HSS were recorded.Results All the 44 patients were followed up for 12 month to 48 months,and the average time was 26 months.There were obviously statistical differences of FTA,joint motion and HSS between preperation and postoperation（P0.005,P0.025,P0.001）.Conclusion Unicompartment knee arthroplasty is less invasive and can make joint function recover well,but the indications are not unified.