Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Meth...Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Methods: From January of 2016 to January of 2017, 20 cases of knee osteoarthritis in medial unicompartment were treated by unicompartmental knee arthroplasty. The knee joint range of motion (ROM), visual analogue scale (VAS) and knee functional Hospital for Special Surgery (HSS) scores were preoperatively recorded. The loss of blood and time of operation were intraoperative recorded. The satisfaction of patient, knee joint range of motion (ROM) and knee functional special surgical hospital score (HSS score) were postoperatively recorded at one year. Results: All patients have been followed up at an average of twelve months. The operation time was 94 - 135 min, mean 105.6 min. The blood loss was 150 - 500 ml, mean 315 ml. The postoperative HSS and ROM were both reduced. The last follow-up, there were no meniscus subluxation, loose prosthesis, and lateral ventricular osteoarthritis or other complications. Conclusion: Unicompartmental knee arthroplasty has the advantages of small operation trauma, early postoperative effect and quick recovery.展开更多
Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can ...Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can be ignored in medial UKA,and others have proposed that this change should be reviewed in PFJ degenerative facets and severity.This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures(PROMs)and revision rates after medial UKA.Methods:Electronic databases(PubMed,Embase,Web of Science,etc.)were searched for studies assessing the influence of PFJ degeneration on medial UKA.A random-effects meta-analysis was conducted for the Oxford knee score(OKS),Knee society score(KSS),and revision rates and stratified by PFJ degenerative facets(medial/lateral/trochlear/unspecified),severe PFJ degeneration(bone exposed),and bearing type(mobile/fixed).Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic.Results:A total of 34 articles with 7007 knees(2267 with PFJ degeneration)were included(5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified).Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS,and only lateral facets significantly decreased the OKS(mean difference[MD]=-2.18,P<0.01)and KSS(MD=-2.61,P<0.01).The severity degree of PFJ degeneration had no additional adverse effect on the OKS,KSS,or revision rates.For mobile-bearing UKA,only lateral PFJ degeneration significantly decreased the OKS(MD=-2.21,P<0.01)and KSS(MD=-2.44,P<0.01).For fixed-bearing UKA,no correlation was found between PROMs/revision rates and PFJ degeneration.Conclusion:For medial mobile-bearing UKA,slight to moderate degenerative changes in the PFJ,except lateral facet,did not compromise PROMs or revision rates.For medial fixed-bearing UKA,although it might not be conclusive enough,PROMs or revision rates were not adversely affected by PFJ degeneration(regardless of the facet).展开更多
目的:探讨单髁关节置换术(Unicompartmental knee arthroplasty,UKA)与全膝关节置换术(Total knee arthroplasty,TKA)对内侧单间室膝骨关节炎患者围术期指标和膝关节功能和术后并发症的影响。方法:回顾性分析2020年3月至2021年6月我院...目的:探讨单髁关节置换术(Unicompartmental knee arthroplasty,UKA)与全膝关节置换术(Total knee arthroplasty,TKA)对内侧单间室膝骨关节炎患者围术期指标和膝关节功能和术后并发症的影响。方法:回顾性分析2020年3月至2021年6月我院收治的内侧单间室膝骨关节炎患者104例的临床资料,根据手术方式分组,有51例患者行单髁置换术归为UKA组,53例行全膝关节置换术为TKA组,比较两组患者围手术期相关指标,评估并比较两组术前、术后6、12个月的膝关节活动度(Range of motion,ROM),美国特种外科医院膝关节(hospital for special surgery knee score,HSS)评分,比较两种手术方法治疗前后下肢力线矫正情况、术后出现并发症的情况。结果:与TKA组相比,UKA组手术时间、自主屈膝90度所用时间更短,术中出血量更少,术后3d血红蛋白下降量较少,两组差异明显(P<0.01);手术前两组患者ROM、HSS评分没有明显差异(P>0.05),术后6、12个月ROM、HSS评分较术前明显增加(P<0.01),且UKA组术后6、12个月的ROM明显高于TKA组(P<0.01),术后6个月UKA组的HSS评分明显高于TKA组(P<0.05);术后两组患者的髋膝踝角较术前增大(P<0.01),胫股角较术前减小(P<0.01),下肢力线得到矫正,两组间髋膝踝角和胫股角差异不明显(P>0.05);UKA组、TKA组术后并发症的发生率分别为3.92%、18.87%,UKA组并发症发生情况明显低于TKA组(P<0.05)。结论:针对内侧单间室膝骨关节炎患者行单髁关节置换术,相比于全膝关节置换术,手术所需时间、自主屈膝90度所用时间更短,术中出血量更少,术后膝关节活动度、关节功能恢复情况更好,术后并发症较少,因此单髁关节置换术值得临床推广使用。展开更多
文摘Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Methods: From January of 2016 to January of 2017, 20 cases of knee osteoarthritis in medial unicompartment were treated by unicompartmental knee arthroplasty. The knee joint range of motion (ROM), visual analogue scale (VAS) and knee functional Hospital for Special Surgery (HSS) scores were preoperatively recorded. The loss of blood and time of operation were intraoperative recorded. The satisfaction of patient, knee joint range of motion (ROM) and knee functional special surgical hospital score (HSS score) were postoperatively recorded at one year. Results: All patients have been followed up at an average of twelve months. The operation time was 94 - 135 min, mean 105.6 min. The blood loss was 150 - 500 ml, mean 315 ml. The postoperative HSS and ROM were both reduced. The last follow-up, there were no meniscus subluxation, loose prosthesis, and lateral ventricular osteoarthritis or other complications. Conclusion: Unicompartmental knee arthroplasty has the advantages of small operation trauma, early postoperative effect and quick recovery.
基金National Natural Science Foundation of China(81802210 and 81672219)Key Project of Sichuan Science&Technology Department(2018SZ0223 and 2018SZ0250)National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University(Z20191008 and Z2018B20)
文摘Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can be ignored in medial UKA,and others have proposed that this change should be reviewed in PFJ degenerative facets and severity.This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures(PROMs)and revision rates after medial UKA.Methods:Electronic databases(PubMed,Embase,Web of Science,etc.)were searched for studies assessing the influence of PFJ degeneration on medial UKA.A random-effects meta-analysis was conducted for the Oxford knee score(OKS),Knee society score(KSS),and revision rates and stratified by PFJ degenerative facets(medial/lateral/trochlear/unspecified),severe PFJ degeneration(bone exposed),and bearing type(mobile/fixed).Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic.Results:A total of 34 articles with 7007 knees(2267 with PFJ degeneration)were included(5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified).Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS,and only lateral facets significantly decreased the OKS(mean difference[MD]=-2.18,P<0.01)and KSS(MD=-2.61,P<0.01).The severity degree of PFJ degeneration had no additional adverse effect on the OKS,KSS,or revision rates.For mobile-bearing UKA,only lateral PFJ degeneration significantly decreased the OKS(MD=-2.21,P<0.01)and KSS(MD=-2.44,P<0.01).For fixed-bearing UKA,no correlation was found between PROMs/revision rates and PFJ degeneration.Conclusion:For medial mobile-bearing UKA,slight to moderate degenerative changes in the PFJ,except lateral facet,did not compromise PROMs or revision rates.For medial fixed-bearing UKA,although it might not be conclusive enough,PROMs or revision rates were not adversely affected by PFJ degeneration(regardless of the facet).
文摘目的:探讨单髁关节置换术(Unicompartmental knee arthroplasty,UKA)与全膝关节置换术(Total knee arthroplasty,TKA)对内侧单间室膝骨关节炎患者围术期指标和膝关节功能和术后并发症的影响。方法:回顾性分析2020年3月至2021年6月我院收治的内侧单间室膝骨关节炎患者104例的临床资料,根据手术方式分组,有51例患者行单髁置换术归为UKA组,53例行全膝关节置换术为TKA组,比较两组患者围手术期相关指标,评估并比较两组术前、术后6、12个月的膝关节活动度(Range of motion,ROM),美国特种外科医院膝关节(hospital for special surgery knee score,HSS)评分,比较两种手术方法治疗前后下肢力线矫正情况、术后出现并发症的情况。结果:与TKA组相比,UKA组手术时间、自主屈膝90度所用时间更短,术中出血量更少,术后3d血红蛋白下降量较少,两组差异明显(P<0.01);手术前两组患者ROM、HSS评分没有明显差异(P>0.05),术后6、12个月ROM、HSS评分较术前明显增加(P<0.01),且UKA组术后6、12个月的ROM明显高于TKA组(P<0.01),术后6个月UKA组的HSS评分明显高于TKA组(P<0.05);术后两组患者的髋膝踝角较术前增大(P<0.01),胫股角较术前减小(P<0.01),下肢力线得到矫正,两组间髋膝踝角和胫股角差异不明显(P>0.05);UKA组、TKA组术后并发症的发生率分别为3.92%、18.87%,UKA组并发症发生情况明显低于TKA组(P<0.05)。结论:针对内侧单间室膝骨关节炎患者行单髁关节置换术,相比于全膝关节置换术,手术所需时间、自主屈膝90度所用时间更短,术中出血量更少,术后膝关节活动度、关节功能恢复情况更好,术后并发症较少,因此单髁关节置换术值得临床推广使用。
