膝关节单髁置换术治疗严重内侧间室骨性关节炎

Unicompartmental knee arthroplasty for serious medial compartmental osteoarthritis of the knee

[目的]探讨膝关节单髁置换术治疗严重内侧间室骨性关节炎的疗效与手术技术。[方法]回顾性分析2008年5月～2009年6月采用膝关节单髁置换术治疗18例(18膝)严重内侧间室骨性关节炎患者的资料,对患者术前、术后膝关节疼痛及关节活动度进行评估(HSS评分法),并测量术后膝关节力线与术前测量结果比较,分析术前病例的选择及手术技术。[结果]术后平均随访18个月(12～24个月),所有病例术后随访时关节内侧间室负重和静息性疼痛症状明显减轻或消失,膝关节活动度达到平均100°(0°～120°);术后力线为平均内翻2°(0°～内翻5°)。HSS评分由术前68分(60～76分)增至85分(78～90分),优良率达89%。[结论]膝关节单髁置换术治疗严重内侧间室骨性关节炎具有较好的疗效,术前病例选择和术中在C型臂机监视下手术操作至关重要。

[Objective]To explore the outcome and surgical technique of unicompartmental knee arthroplasty（UKA） for serious medial compartmental osteoarthritis of the knee.[Methods]Eighteen patients（18 knees） with serious medial compartmental osteoarthritis of knee treated by UKA from May 2008 to June 2009 were reviewed and analyzed.The pain and range of motion（ROM） of the knees were evaluated by HSS score system before and after UKA.Pre-and postoperative alignment of the lower limbs were measured and compared.Surgery indications and surgical technique of UKA were also summarized.[Results] Eighteen knees of 18 patients were followed up for a mean time of 18 months（12～24 months）.The pain over medial compartment of the knees were subsided or relieved in all cases.The post-operative ROM of the knees were 0°～120°（mean 100°）,and alignment was 2°varus on the average（0°～ 5°varus）.HSS score increased from 68（60～76） to 85（78～90）.The excellent and good results accounted for 89%.[Conclusion]UKA is an effective method for serious medial compartmental osteoarthritis of the knee.Surgical indications and surgical technique with C-arm monitoring are the key factors for the final results.