单髁置换术治疗高龄膝关节骨性关节炎合并髌股关节炎的疗效

Efficacy of unicondylar replacement in the treatment of elderly knee osteoarthritis combined with patellofemoral arthritis

目的探讨单髁置换术治疗70岁以上膝关节内侧间室骨性关节炎合并髌股关节炎患者的中短期疗效。方法回顾性分析我院收治的56例(58膝)70岁以上合并髌股关节炎的膝关节内侧间室退变患者的临床资料,所有患者均行单髁置换术。采用视觉模拟量表(VAS)评分评价患者膝关节疼痛情况,采用美国特种外科医院(HSS)评分评价患者膝关节功能,观察记录患者膝关节活动度情况。结果本组患者均顺利完成手术,无术中及术后并发症发生。术后1周膝前疼痛VAS评分、膝内侧疼痛VAS评分均较术前降低,膝关节功能HSS评分较术前增加,膝关节活动度较术前增加,差异均有统计学意义(P<0.05)。术后随访24~36个月,未观察到髌股关节炎进一步发展。结论单髁置换术治疗高龄患者膝关节内侧间室关节炎合并骨性髌股关节炎的中短期效果优良。

Objective To investigate the short-and medium-term curative effects of unicondylar replacement in the treatment of medial compartmental osteoarthritis of the knee combined with patellofemoral arthritis in patients over 70 years old.Methods The clinical data of 56 patients(58 knees)over 70 years old with medial compartmental degeneration of the knee joint combined with patellofemoral arthritis in our hospital were retrospectively analyzed.All patients underwent unicondylar replacement.The visual analogue scale(VAS)score was used to evaluate the pain of knee joint,the American hospital for special surgery(HSS)score was used to evaluate the function of knee joint,and the range of motion of knee joint was observed and recorded.Results All the patients completed the operation successfully,and no intraoperative or postoperative complications occurred.The VAS score of anterior knee pain and the VAS score of medial knee pain 1 week after operation were all lower than those before operation,the HSS score of function of knee joint was higher than that before operation,and the range of motion of knee joint was greater than that before operation,and the differences were statistically significant(P<0.05).After followed up for 24 to 36 months,no further development of patellofemoral arthritis was observed.Conclusion The unicondylar replacement has good short-and medium-term effects in the treatment of medial compartmental osteoarthritis of knee combined with patellofemoral arthritis in elderly patients.