单髁置换术治疗膝内侧间室骨关节炎近中期疗效评价

Short and Mid-term Outcomes of Unicompartmental Knee Arthroplasty for Medial Com Arthroplasty for Medial Compartmental Knee Osteoarthritis

目的:评价单髁置换术(unicompartmental knee arthroplasty,UKA)治疗膝内侧间室骨关节炎疗效。方法:回顾分析2017年1月-2020年10月采用OxfordⅢ活动平台行UKA术治疗的77例膝内侧间室骨关节炎患者,比较术前及末次随访时患膝疼痛视觉模拟(VAS)评分、患膝关节活动度(ROM)、患肢机械轴股骨-胫骨角(mFTA)、牛津大学膝关节评分(OKS);评估术后12个月及末次随访时的关节遗忘评分(FJS),记录随访期间并发症及末次随访时的关节假体生存情况。结果:77例患者随访时间16-61个月,平均(39.6±6.8)个月;患膝VAS评分由术前(6.1±0.6)分降至末次随访时的(1.2±0.3)分,ROM由术前的(111.7±5.6)度改善至末次随访时的(120.3±8.4)度,mFTA由术前(7.1±2.2)度矫正至末次随访时的(3.2±0.9)度,OKS评分由术前的(40.8±3.6)分改善至末次随访时的(24.6±3.1)分,FJS评分在术后12月时为(61.7±2.2)分,末次随访时为(70.9±1.3)分,差异均有统计学意义(P<0.05)。随访期间3例患膝残留痛,无血管、神经损伤和感染等并发症。至末次随访无假体松动、假体周围骨折以及衬垫脱位等,假体生存率100%。结论:采用OxfordⅢ活动平台行UKA术治疗膝内侧间室骨关节炎能有效缓解临床症状,改善关节功能,并发症少,近中期疗效满意。

Objective:To evaluate the outcomes of unicompartmental knee arthroplasty(UKA)for medial compartmental knee osteoarthritis.Methods:From January 2017 to October 2020,77 patients with medial compartment knee osteoarthritis were treated by OxfordⅢUKA,and the outcomes were retrospectively analyzed.The outcomes were assessed with the visual analogue scale(VAS score),range of motion(ROM),mechanical femoral tibial angle(mFTA)and Oxford knee score(OKS)before the operation and at the last follow-up.The joint forgetting score(FJS)was also evaluated at 12 months after operation and at the last follow-up.The complications and prosthesis survival were evaluated too.Results:77patients were followed up for 16 to 61 months,with an average of(39.6±6.8)months.The VAS score was significantly decreased from(6.1±0.6)pre-operatively to(1.2±0.3)at the last follow-up(P<0.05).The ROM was significantly increased from(111.7±5.6)pre-operatively to(120.3±8.4)at the last follow-up(P<0.05).The mFTA was significantly increased from(7.1±2.2)pre-operatively to(3.2±1.9)度at the last follow-up(P<0.05).The OKS was significantly decreased from(40.8±3.6)pre-operatively to(24.6±3.1)at the last follow-up(P<0.05).The FJS was(61.7±2.2)at 12 months after operation,and was(70.9±2.3)at the last follow-up,showed significant increased(P<0.05).No serious complications,such as vascular and nerve injury,infection were found during followed-up time,however,persist residual pain was found in 3 patients post-operatively.At the last follow-up,there were no prosthesis loosening,fracture around the prosthesis,dislocation of polyethylene liner,etc,and the survival rate of the prosthesis was 100%.Conclusion The OxfordⅢUKA for medial compartment knee osteoarthritis can effectively relieve clinical symptoms,improve joint function,and have fewer complications and the short and mid-term outcomes are satisfactory.