膝关节单髁置换活动与固定平台短期疗效分析

Short-term clinical outcomes of mobile bearing and fixed bearing unicompartmental knee arthroplasty

目的比较内侧膝关节单髁假体置换术中活动平台和固定平台治疗膝关节骨关节炎的短期疗效,探讨不同假体翻修率的差异以及并发症的不同。方法回顾性分析2015年5月至2016年12月收治的113例(133膝)膝关节内侧骨关节炎患者资料。根据假体不同分为活动平台和固定平台两组。术后比较两组患者膝关节疼痛、关节活动度、美国膝关节协会评分(Knee Society Score,KSS)等。结果术后患者均获得随访,随访时间6~24个月,平均17.5个月,随访中1例活动平台组患者术后4个月发生半月板衬垫移位脱出,1例活动平台组、1例固定平台组患者术后出现切口红肿破溃。随访期间无一例发生关节内感染以及假体松动移位等。活动平台组KSS评分术前为(48.45±9.17)分,术后为(84.54±8.44)分;固定平台组KSS评分术前为(49.88±12.02)分,术后为(86.40±7.18)分,术前与术后比较,差异有统计学意义。组间KSS评分比较,差异无统计学意义。结论单髁膝关节置换治疗膝关节内侧间室骨关节炎在术后的短期随访中活动平台与固定平台术后的临床结果无明显差异;短期内两种平台假体的翻修率低,但导致翻修的并发症有所不同。

Objective To compare the short-term clinical outcomes of unicompartmental knee arthroplasty （UKA） between mobile bearing and fixed bearing, and to investigate the difference of revision rate and complication. Methods From May 2015 to May 2016, data of 113 patients （133 knees） underwent UKA were retrospectively analyzed. All patients were divided in two groups according to the prosthesis. The pain and the knee function as well as knee society score （KSS） were recorded both pre and post-operatively. Results All patients were followed up for 6 months to 24 months （average 17.5 months）. During follow-up, 1 cases of mobile bearing group had postoperative meniscal pad displacement and dislocation in April. 1 cases of mobile bearing group and 1 cases of fixed bearing group had postoperative incision swelling and ulceration. Therewerenojointinfectionandprostheticloosening, etc. The KSS in mobile bearing group was 48.45±9.17 preoperatively and 84.54±8.44 postoperatively. While the KSS in fixed bearing group was 49.88±12.02, and 86.40±7.18, respectively. There were statistical differences comparing between preoperative and pos- toperative KSS knee scores. There was no significant difference in KSS scores between mobile bearing group and fixed bearing group. Conclusion There was no significant difference in clinical outcomes between mobile bearing and fixed bearing in terms of clinical and functional outcomes in this short-term follow-up study. The revision rate was both low but the complications resulting from revision were different.