微创单髁置换治疗膝关节前内侧单间室骨关节炎:6个月随访

Unicompartmental knee arthroplasty for anterior-medial unicompartmental knee osteoarthritis: a 6-month follow-up

背景:近年来微创单髁膝关节置换术广泛应用于治疗膝关节前内侧骨性关节炎,并被公认最为行之有效的治疗方法之一。目的:探讨单髁置换治疗膝关节前内侧单间室骨关节炎的近期临床疗效。方法:回顾性分析长治医学院附属和平医院2014年5月至2016年5月收治的42例(48膝)经单髁置换治疗的膝关节前内侧单间室骨性关节炎患者的临床资料。通过门诊及电话随访,对照术前与术后末次随访的美国特种外科医院膝关节评分(HSS)、美国膝关节协会评分(KSS)、西安大略和麦柯玛斯大学骨关节炎评分(WOMAC)及关节活动度来分析单髁置换治疗膝关节前内侧间室骨性关节炎的近期临床疗效。结果与结论:(1)术后随访6-24个月;(2)术后患者关节内侧疼痛均得到不同程度的缓解,HSS评分、KSS评分、WOMAC评分、膝关节活动度等在术前和末次随访时比较差异均有显著性意义(P<0.05);(3)术后无下肢深静脉血栓、肺栓塞、感染、活动半月板脱位及假体松动等并发症发生;(4)结果提示,单髁置换治疗膝关节前内侧单间室骨关节炎具有创伤小、恢复快、并发症少等优点,近期临床疗效肯定,远期疗效有待进一步验证。

BACKGROUND： Unicompartmental knee arthroplasty （UKA） has been widely applied in the treatment of anterior-medial osteoarthritis of the knee and is widely recognized as one of the most effective treatments.OBJECTIVE： To explore the short-term efficacy of UKA for anterior-medial unicompartmental knee osteoarthritis. METHODS： Clinical data of 42 patients （48 knees） with anterior-medial unicompartmental knee osteoarthritis undergoing UKA in Heping Hospital Affiliated to Changzhi Medical College from May 2014 to May 2016 were analyzed retrospectively. The preoperative and postoperative last follow-up Hospital for Special Surgery, the Knee Society Score, Western Ontario and Macmaster scores, as well as the range of motion of the knee were compared through clinic reexamination or telephones to evaluate the short-term efficacy. RESULTS AND CONCLUSION： （1） The follow-up time was 6-24 months. （2） The pain of the medial knee joint was relieved in different degrees, and there were significant differences in the Hospital for Special Surgery, the Knee Society Score, Western Ontario and Macmaster scores, as well as the range of motion of the knee between preoperation and postoperation （P 〈 0.05）. （3） No lower limb deep vein thrombosis, pulmonary embolism, infection, meniscus dislocation or prosthesis loosening occurred. （4） To conclude, UKA exhibits less trauma, rapid recovery and less complications in the treatment of anterior-medial unicompartmental knee osteoarthritis, which obtains good short-term efficacy, and its long-term efficacy needs to be studied in depth.