Oxford活动型半月板双极膝关节单髁置换术在单间室骨性关节炎中的临床应用

CLINICAL APPLICATION OF OXFORD MOBILE-BEARING BIPOLAR PROSTHESIS UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR SINGLE COMPARTMENTAL KNEE OSTEOARTHRITIS

目的探讨采用Oxford活动型半月板双极膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)治疗单间室骨性关节炎的临床疗效。方法 2011年6月-2013年7月,采用Oxford活动型半月板双极UKA治疗22例(22膝)单间室骨性关节炎。其中男8例,女14例;年龄45~80岁,平均65岁。体质量50~65 kg,平均55.2 kg;体质量指数17~25 kg/m^2,平均20.8 kg/m^2。左膝12例,右膝10例。病程8~90个月,平均32.5个月。均为内侧间室骨性关节炎。术前、术后1周及末次随访时采用膝关节学会评分系统(KSS)评价膝关节功能,并测定膝关节活动度(range of motion,ROM)。结果术后患者切口均Ⅰ期愈合,无下肢深静脉血栓形成,泌尿系统、肺部感染及压疮等早期并发症发生。22例患者均获随访,随访时间2~4年,平均3.2年。随访期间X线片示假体位置良好,无假体脱位、假体周围感染等并发症发生。术后1周及末次随访时患膝关节ROM及KSS功能评分和临床评分均较术前显著改善,差异有统计学意义(P<0.05);术后两个时间点间比较差异无统计学意义(P>0.05)。结论采用Oxford活动型半月板双极UKA治疗膝关节单间室骨性关节炎创伤小,可早期行功能锻炼,术后关节活动更接近生理状态,且降低了并发症风险。

Objective To evaluate the effectiveness of Oxford mobile-bearing bipolar prosthesis unicompartmental knee arthroplasty（UKA） in the treatment of single compartmental knee osteoarthritis. Methods Between June 2011 and July 2013, 22 cases of single compartmental knee osteoarthritis were treated by Oxford mobile-bearing bipolar prosthesis UKA. Of 22 cases, 8 were male and 14 were female with an average age of 65 years（range, 45-80 years）; the left knee was involved in 12 cases, and the right knee in 10 cases, with a mean disease duration of 32.5 months（range, 8-90 months）. The mean weight was 55.2 kg（range, 50-65 kg）, and the mean body mass index was 20.8 kg/ m^2（range, 17-25 kg/m^2）. Osteoarthritis involved in the single knee medial compartment in all patients. Knee society score（KSS） and range of motion（ROM） were measured to evaluate the knee joint function. Results Primary healing of incision was obtained in all patients, and there was no complication of infection, bedsore, or deep venous thrombosis. Postoperative follow-up was 2-4 years（mean, 3.2 years）. The X-ray films showed good position of prosthesis, no prosthesis dislocation, or periprosthetic infection during follow-up. Knee ROM, KSS function score, and KSS clinical score were significantly improved at 1 week after operation and at last follow-up when compared with preoperative ones（P〈0.05）, but no significant difference was shown between at 1 week and at last follow-up（P〉0.05）. Conclusion Oxford mobile-bearing bipolar prosthesis UKA is an effective method to treat single compartmental knee osteoarthritis, with the advantages of less trauma, earlier rehabilitation exercise, near physiological state in joint function, and less risk of complications.