Oxford第三代单髁系统治疗单纯膝关节内侧间室骨关节炎患者的初期疗效

Early effects of Oxford Ⅲ unicompartment system in treatment of single anteriomedialis compartmental arthrosis

目的:探讨采用膝关节单髁置换系统(UKA)治疗单纯膝关节内侧间室骨关节炎患者的初期临床疗效,为临床治疗单纯膝关节内侧间室骨关节炎方案选择提供依据。方法:回顾性分析采用膝关节单髁置换系统治疗单纯膝关节内侧间室骨关节炎患者23例(23膝)。对所有患者进行随访,分别从手术切口长度、手术时间、术中出血量、术后疼痛(VAS评分)、术后首次直腿抬高时间、平均住院天数,术后1年膝关节活动度(ROM),术后1年及末次随访HSS评分进行分析。结果:所有患者均获完整随访。无1例患者出现感染、血管神经损伤、术后衬垫脱位等并发症。1例术后1个月因骨水泥松动行全膝关节翻修术,2例报告膝关节残余疼痛,不剧烈可耐受。经统计学分析,相比于全膝关节表面置换文献报道,本组患者在手术切口长度、术中出血量、术后VAS评分、首次直腿抬高时间及平均住院天数等方面具有显著优势。结论:膝关节单髁置换系统只重建病变的间室、保留正常的间室和正常的韧带结构,具有创伤小,术后恢复快,患者满意度高等优点,对于经严格选择的膝关节单间室骨关节炎患者其初期疗效优于全膝关节表面置换。

Objective：To investigate early effects of unicompartmental knee arthroplasty （ UKA） in treatment of single anterio-medialis compartmental arthrosis, in order to provide a clinical evidence to the clinical treatment of this disease. Methods：23patients （23 knees） diagnosed with single anteriomedialis compartmental arthrosis and undergone UKA were retrospectively analyzed. These pa-tients were followed up and evaluated from the skin incision length, time of operation, amount of bleeds, postoperative VAS score, ac-tive straight-leg raise time, average stay, range of motion at 1 year postoperatively, postoperative HSS scores at 1 year and latest follow-up. Results：Total 23 patients obtained complete follow-up, and no infections, vascular nerve injury, and postoperative liner dislo-cations occurred. 1 case suffered from total knee revision due to bone cement loosening, and 2 cases reported a residual pain, which was not severe and could be tolerable. The statistical analysis showed that compared with related TKA reports, UKA had obvious ad-vantages in skin incision length, amount of bleeds, postoperative VAS score, active straight-leg raise time and average stay. Conclu-sions：UKA can retain the health compartments and normal ligament structure but only reconstruct the damaged compartment in order to promote the recovery of knee joint function and can obtain satisfied early therapeutic effect in carefully selected patients with less trau-ma, rapid recovery and high satisfaction.