微创单髁置换术治疗膝内侧间室骨性关节炎的早期并发症

The early complications of minimally invasive unicompartmental knee arthroplasty for the treatment of medial compartmental knee osteoarthritis

[目的]回顾性分析微创单髁置换术后的早期并发症。[方法]从2005年5月～2010年1月,共有52例患者(56膝)在本院接受微创单髁置换术,其中男19例(21膝),女33例(35膝),平均年龄65.2岁(46～78岁),单侧48例,双侧4例,体重平均68.3 kg(55～80 kg),身高平均162.2 cm(148～178 cm),BMI平均26.4(19.6～34.6)。所用假体均为骨水泥型Oxford phase 3代。[结果]52例患者获得完整随访,随访平均18.3个月(12～31个月)。1例术后X线摄片发现内侧胫骨平台轻度劈裂,但骨折无明显移位,1例发生可移动半月板衬垫后方脱位。无1例发生浅表或深部感染、脂肪栓塞或下肢深静脉血栓、假体松动等并发症。末次随访HSS评分和膝关节活动度明显增加,下肢力线内翻畸形明显减少。[结论]微创单髁置换术治疗早期单间室骨性关节炎疗效确切,功能恢复满意,但是手术技巧的熟练掌握和规范的术后康复训练指导非常必要。

To review and analyze the early complications of minimal invasive unieompartmental knee arthroplasty（UKA）. [ Method] Between May 2005 and January 2010,52 consecutive cases （56 knees）consisting of 19 males and 33 females with mean age 65.2 years （range 60 -72 years） , mean weight 68.3kg （range 55 -80kg） , mean height 162.2cm（ range 148 ~ 178 em） and mean BMI 26.4（ range 19.6 - 34.6）were enrolled. There were 48 cases in unilateral knee and 4 cases in bi- lateral knees. All cases were operated with Oxford Phase 3 UKA. [ Result] The mean follow - up were 18.3 months （ range 12 N 31 months）. One ease was found to have fracture of the medial tibial plateau without displacement and was treated with conserva- tive treatment. The other was found to have disloeation of the meniseai bearing. None had complications of infection, fat embolism or DVT, and component loosening. All cases achieved significant improvement of HSS score and ROM, and correction of varus deformity. [ Conclusion] Minimal invasive unieompartmental knee arthroplasty（UKA） has a definitely curative effect on the early medial compartmental knee osteoarthritis. However, mastery of surgical skills and standardized postoperative rehabilitation guide- line are essential in order to minimize these complications.