单髁膝关节置换术治疗膝前内侧间室骨性关节炎的疗效

The efficacy of unicompartmental knee arthroplasty in the treatment of anteromedial compartmental osteoarthritis of the knee

目的探讨单髁膝关节置换术(UKA)治疗膝前内侧间室骨性关节炎的疗效。方法采用UKA治疗78例膝前内侧间室骨性关节炎患者(90膝)。记录手术时间、术中出血量、术后输血情况、膝关节活动度、术后并发症发生情况。采用HSS评分评价手术疗效。结果患者均获得2年随访。患者均未出现术后感染、假体脱位或松动、外侧间室骨性关节炎等需行翻修术的严重并发症。每膝手术时间55~85(69.30±13.45)min,术中出血量160~250(213.00±27.86)ml。2例双侧同时手术者输注红细胞悬液。术后3 d、1个月、2年膝关节屈曲活动度依次为90°~100°(95.11°±3.42°)、100°~125°(112.00°±10.55°)、100°~140°(117.00°±18.46°);HSS评分依次为68~86(76.06±7.68)、71~85(78.00±6.98)、80~105(92.01±10.24)分。末次随访时患者均可完全负重行走,行走时无明显疼痛。结论UKA能有效治疗膝前内侧间室骨性关节炎,但需注意把握手术适应证。

Objective To investigate the efficacy of unicompartmental knee arthroplasty(UKA)in the treatment of anteromedial compartmental osteoarthritis of the knee.Methods UKA was used to treat 78 patients with anteromedial compartment osteoarthritis of the knee(90 knees).The operation time,intraoperative blood loss,postoperative blood transfusion situation,knee joint mobility and postoperative complications were recorded.The HSS score was used to evaluate the effect of operation.Results All patients were followed up for two years.There were no severe complications such as postoperative infection,dislocation,loosening of the prosthesis and lateral compartment osteoarthritis which required revision surgery.The operation time of each knee was 55~85(69.30±13.45)min.The intraoperative blood loss was 160~250(213.00±27.86)ml.Red Blood cell suspension was infused into 2 patients who underwent bilateral operation simultaneously.The flexion range of the knee was 90°~100°(95.11°±3.42°),100°~125°(112.00°±10.55°),100°~140°(117.00°±18.46°)at 3 d,1 month and 2 years postoperation,and the HSS scores were 68~86(76.06±7.68),71~85(78.00±6.98)and 80~105(92.01±10.24)points,respectively.At the last follow-up,all patients could walk with complete weight-bearing,without obvious pain.Conclusions UKA can effectively treat anteromedial compartment osteoarthritis of the knee,but the indication of operation should be strict.