单髁置换术联合关节镜治疗膝前内侧骨关节炎伴外侧半月板退变患者的疗效

Efficacy of Unicondylar Knee Arthroplasty Combined with Arthroscopy in the Treatmentof Knee Anteromedial Osteoarthritis with Lateral Meniscus Degeneration

目的探讨单髁置换术联合关节镜治疗膝前内侧骨关节炎伴外侧半月板退变患者的疗效。方法回顾性分析2015年1月~2019年10月我院收治的膝前内侧骨关节炎伴外侧半月板退变患者38例作为研究对象,均采用关节镜对外侧退变变性撕裂半月板修整成形术,内侧间室行单髁置换术。随访4~42个月,观察随访期间并发症发生情况,并比较术前与术后疼痛情况情况和膝关节功能情况。结果 38例患者均获得随访,术后平均随访时间(13.00±3.00)个月,随访期间未出现严重神经血管损伤、翻修、假体松动、感染、深静脉血栓和假体脱位等需要再次入院的严重并发症。术后VAS评分低于术前[(1.60±0.80)分vs(5.60±1.10)分],改良WOMAC评分及KSS评分中临床评分和功能评分高于术前[(93.20±7.20)分vs(51.10±6.80)分]、[(91.50±8.30)分vs(61.50±9.00)分]、[(86.40±11.50)分vs(58.60±8.20)分],差异有统计学意义(P<0.05)。X线未见明显假体移位、脱位和松动等情况,未见假体周围出现宽度>1 mm的显著透亮线,术后切口良好。结论单髁置换术联合关节镜治疗膝前内侧骨关节炎伴外侧半月板退变患者,可有效缓解患者症状,促进膝关节功能恢复,且假体固定的稳定性较好,无严重并发症发生。

Objective To investigate the effect of unicondylar knee arthroplasty combined with arthroscopy in the treatment of knee anteromedial osteoarthritis with lateral meniscus degeneration.Methods A retrospective analysis of 38 patients with anterior medial knee osteoarthritis with lateral meniscus degeneration admitted to our hospital from January 2015 to October 2019 were used as the research objects,all of which were used arthroscopy to repair and shape the lateral degenerative tear meniscus surgery,unicondyler knee arthroplasty in the medial compartment.The patients were followed up for 4 to 42 months to observe the occurrence of complications during the follow-up period,and compare the pain and knee joint function before and after the operation.Results All 38 patients were followed up with an average follow-up time of(13.00±3.00)months.During the follow-up period,there were no serious neurovascular injuries,revisions,prosthesis loosening,infections,deep vein thrombosis,and prosthesis dislocations that required re-admission.complication.The postoperative VAS score was lower than preoperative[(1.60±0.80)points vs(5.60±1.10)points],and the clinical and functional scores in the modified WOMAC score and KSS score were higher than preoperative[(93.20±7.20)points vs(51.10±6.80)points],[(91.50±8.30)points vs(61.50±9.00)points],[(86.40±11.50)points vs(58.60±8.20)points],the difference was statistically significant(P<0.05).X-rays showed no obvious displacement,dislocation and loosening of the prosthesis,no obvious translucent lines with a width>1 mm around the prosthesis,and a good postoperative incision.Conclusion Unicondylar knee arthroplasty combined with arthroscopy for the treatment of patients with anterior medial knee osteoarthritis with lateral meniscus degeneration can effectively relieve the symptoms of the patients,promote the recovery of knee joint function,and the stability of the prosthesis is good without serious complications.