微创膝关节单髁置换中期临床疗效研究

Mid-term clinical outcome of unicompartmental knee replacement by minimally invasive approach

目的前瞻性研究微创膝关节单髁置换术（UKR）治疗膝内侧室骨关节病的中期临床疗效。方法对自2006年1月～2008年6月采用OxfordphaseⅢ假体行微创（MIS）一UKR的56例患者（60膝）进行了中期临床疗效的分析，并从影像学、KSS评分、WOMAC评分以及VAS评分等方面进行疗效评价。结果平均随访时间（73．0±2．4）个月；所有患者无术后感染、血栓形成、活动半月板脱位等并发症；无一例翻修病例；无死亡病例；KSS临床和功能评分分别由术前平均（41．2±3．3）分和（52．1±4．6）分增至术后（94．8±4．1）分和（93．8±3．2）分；WOMAC评分由术前平均（46．7±3．6）分减少为术后（11．4±1．8）分；VAS评分由术前平均（7．39±1．25）分降为术后（1．72±0．36）分；各项指标手术前后比较均有统计学差异（P均〈0．05）。结论MIS—UKR中期临床疗效满意，是治疗膝关节内侧室骨关节病的一个良好的手术选择。

Objective To study the mid-term clinical outcome of unicompartmental knee replacement （UKR） using a minimally invasive approach for the patients with medial knee arthropathy. Methods 60 knees in 56 patients received the UKR with the mobile bearing Oxford phase Ⅲ prosthesis by a minimally invasive approach from January 2006 to June 2008. A prospective study of the clinical outcomes was carried out. All patients were evaluated pre- and post-operatively using X-ray image, the Knee Society Score （KSS）, the WOMAC osteoarthritis index and VAS score. Results The average follow-up time was （73 ± 2.4） months. No patient had the complications of infection, thrombosis, mobile beating dislocation. No revision surgery was performed. The KSS Clinical Score and Function Score were improved from an average of （41.2 ±3.3） and （52.1 ±4.6） to （94.8 ±4.1） and （93.8 ±3.2） respectively. The average WOMAC Score was （46. 7 ±3.6） preoperatively, and （11.4± 1.8） at the last evaluation. The VAS score dropped from （7.39±1.25 ） preoperatively to （ 1.72 ± 0. 36） postoperatively. Statistically significant differences were found pre- and post-operatively from the aforementioned evaluation criteria（P 〈 0. 05 ）. Conclusion The mid-term clinical outcomes of medial-Oxford-phrase Ⅲ mobile- bearing UKR through a minimally invasive approach are satisfactory, and it is a good therapy choice for the patients with medial arthropathy of the knee.