Oxford活动平台单髁置换术治疗内侧间室膝关节骨性关节炎的中期疗效观察

Mid-term effectiveness of Oxford mobile plateau in unicompartment arthroplasty for medlal knee osteoarthritis

目的 探讨膝关节内侧间室重度骨性关节炎采用Oxford活动平台单髁关节置换术治疗的中期疗效。方法 自2010-01—2014-12采用Oxford活动平台单髁关节置换术诊治58例（65膝）膝关节单纯内侧间室重度骨性关节炎。结果本组手术时间平均71（52-86）min,术中失血量为（97.1±13.3）ml,所有患者均未输血。均获平均25.2（12-46）个月随访。术后切口均一期愈合,无急性期感染发生。股胫角由术前的平均内翻4.8°改善为术后的平均外翻5.3°。膝关节活动度术前（85.2±9.3）°,末次随访时（132.0±11.4）°。膝关节功能KSS评分术前（21.6±4.9）分,末次随访时（82.7±8.1）分;HSS功能评分术前（47.2±6.9）分,末次随访时（81.5±10.4）分;末次随访时膝关节活动度、膝关节功能KSS评分和HSS功能评分与术前比较,差异均有统计学意义（P〈0.05）。1例行双膝同期单髁置换,1年后左膝出现迟发性感染,假体松动,行全膝关节翻修。其余患者未见假体松动、塌陷及移位;对侧间室及髌股关节无明显进行性退变。结论 对于膝关节单纯内侧间室受累所导致的重度骨性关节炎,采用Oxford单髁关节假体置换治疗具有手术时间短,手术损伤小,失血少,恢复快,中短期疗效确切等优点,长期疗效有待进一步随访。

Objective To observe mid-term effectiveness of Oxford mobile plateau used in unicompartment arthroplasty for medial knee osteoarthritis. Methods From January 2010 to December 2014, 58 patients（65 knees） with medial knee osteoarthritis were treated with Oxford mobile plate unicompartment arthroplasty. Results The average operation time of this group was 71（52-86）minutes, blood loss volume during operation was（97.1 ±13.3）ml. All patients did not receive blood transfusion. All patients were followed up in average 25.2 months（range of 12-46 months） and all the incisions were primary healing without infection in prophase. The femor-tibial angles of these patients were improved from varus 4.8 °preoperatively to valgus 5.3° postoperatively and the range of motion were raised from（85.2±9.3）° to（132.0±11.4）° and the HSS scores were increased from（21.6±4.9） to（82.7±8.1）,HSS functional scores were increased from（47.2±6.9） to（81.5±10.4） at the last time follow up. One patient who underwent double knees synchronization with unicompartment arthroplasty received left knee revision because of its tardive infection so that inserts were loosening 1 year later. There were no inserts loosening, collapse,transposition progressive degeneration in lateral compartment and patellofemoral joint. Conclusion Oxford unicompartment system has the advantages of short-time operation, little trauma, rapid recovery for severe medial knee osteoarthritis. The midterm effectiveness is satisfactory, but its long-term effectiveness needs further follow-up.