BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to pat...BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.展开更多
AIM To compare clinical outcomes of patients with and without preoperative genu recurvatum(GR) following mobile bearing unicompartmental knee arthroplasty(UKA). METHODS We prospectively followed 176 patients for at le...AIM To compare clinical outcomes of patients with and without preoperative genu recurvatum(GR) following mobile bearing unicompartmental knee arthroplasty(UKA). METHODS We prospectively followed 176 patients for at least 24 mo who had been treated by unilateral, minimally invasive, Oxford UKA. Patients with medial osteoarthritis(OA) knee and preoperative GR(Group Ⅰ) accounted for 18%(n = 32) and patients without preoperative GR(Group Ⅱ) accounted for the remaining 82%(n = 144). Knee score, pain scores, and functional scores were assessed for each patient and compared between the two groups. The incidence of postoperative GRand the postoperative hyperextension angles also were recorded and analyzed. RESULTS The pain score, knee score and functional score were not significantly different between the two groups. Similarly, the incidence of postoperative GR and the measured hyperextension angles were not significantly different between the two groups. The incidence of postoperative GR was 1/32(3.12%) in Group Ⅰ and 1/144(0.69%) in Group Ⅱ(P = 0.34). The mean postoperative hyperextension angles were 2.40°± 2.19°(range: 1°-7°) for Group Ⅰ and 1.57°± 3.51°(range: 1°-6°) for Group Ⅱ(P = 0.65).CONCLUSION Medial OA of the knee and concomitant GR is not a contraindication for the mobile bearing UKA.展开更多
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
Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA w...Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA was confirmed by radiography in all patients, who were divided into three groups: exercise (n = 44), insole (n = 55), and brace (n = 19). Clinical knee functions and gait analyses were evaluated. Results: After 12 months, the clinical results for all groups had improved compared to pretreatment findings. Although the knee varus moment decreased and the gait speed increased when the insole was worn initially, the effects of the insole decreased at 6 and 12 months. In contrast, the knee varus moment decreased and the gait speed increased when the brace was initially fitted. The effects of the brace were maintained during the 12 months. Conclusions: The insole was effective for patients with Kellgren-Lawrence Grades II and III, and the knee brace was effective for patients with Grades III and IV conditions. Furthermore, the knee brace was more effective when worn for more than 6 months, while the effects of the insoles were not continuous.展开更多
BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patient...BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.展开更多
The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage kn...The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage knee osteoarthritis (OA). Women presenting with knee pain were recruited into a cross-sectional correlation study (KOA, n = 9, age = 52 ± 4 yrs). Self report menstrual history, the Modified Baecke Questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subjective data were collected. A fasting blood sample (follicle stimulating hormone (FSH) and Tumor Necrosis Factor-α (TNF-α)), and urine catch (16α-hydroxyestrone and 2-hydroxyestrone) were collected. Gait analysis using an 8-camera motion analysis system assessed internal knee varus moment and foot progression angle. Pearson Product moments tested for associations between urinary 16α-hydroxyestrone and 2-hydroxyestrone, TNF-α, medial knee loading, and radiographic disease severity (Kellgren/Lawrence (K/L) radiographic score). Significant correlations were found within the hormonal biomarkers (r = 0.94, p p p = 0.31). No correlations were found for radiographic disease severity or TNF-α. The lack of association between hormonal and biomechanical variables could be due to large variability of the E2 metabolites seen in the menopause transition and the limited structural changes of initial staged knee OA.展开更多
目的观察固定平台单髁置换加髁间窝成形术治疗中度固定屈曲畸形膝内侧间室骨关节炎的临床效果。方法选取2021年11月至2023年6月青岛市市立医院收治的合并有中度固定屈曲畸形的膝内侧间室骨关节炎患者50例,其中男24例,女26例,年龄64~75岁...目的观察固定平台单髁置换加髁间窝成形术治疗中度固定屈曲畸形膝内侧间室骨关节炎的临床效果。方法选取2021年11月至2023年6月青岛市市立医院收治的合并有中度固定屈曲畸形的膝内侧间室骨关节炎患者50例,其中男24例,女26例,年龄64~75岁,平均(69.69±3.53)岁。按手术方式分为研究组(采用固定平台单髁置换加髁间窝成形术)和对照组(采用全膝关节表面置换术)各25例。对比两组手术前后Lysholm评分、美国特种外科医院(the hospital for special surgery,HSS)膝关节评分及疼痛视觉模拟评分(visual analogue scale,VAS),测量术前及术后12个月膝关节屈曲角度,对比两组伸膝角度改善情况。结果患者均获得12个月完整随访。术后2周、6周、3个月研究组Lysholm评分、HSS评分及VAS均优于对照组,差异有统计学意义(P<0.05);两组术后6个月、12个月Lysholm评分、HSS评分及VAS差异均无统计学意义(P>0.05);研究组术后12个月残留畸形角度大于对照组,差异有统计学意义(P<0.05)。结论对老年骨关节炎合并中度固定屈曲畸形患者采取固定平台单髁置换加髁间窝成形手术可以有效地减轻疼痛,改善膝关节功能,但对屈曲畸形的矫正能力小于全膝关节置换。展开更多
目的观察活动平台与固定平台单髁置换术对膝骨性关节炎手术治疗的短期疗效。方法选取内侧单间室膝骨关节炎患者155例,均行人工单髁置换术,其中97例选择美国邦美Oxford第三代活动平台(mobilebearing,MB)单髁假体,58例选择德国LINK固定平...目的观察活动平台与固定平台单髁置换术对膝骨性关节炎手术治疗的短期疗效。方法选取内侧单间室膝骨关节炎患者155例,均行人工单髁置换术,其中97例选择美国邦美Oxford第三代活动平台(mobilebearing,MB)单髁假体,58例选择德国LINK固定平台(fixed-bearing,FB)单髁假体。比较两组手术时间及术中出血量;术前及术后1周、1个月视觉模拟评分(VAS);术前及术后1个月、3个月、6个月膝关节活动度(range of motion,ROM)及美国特种外科医院(hospital for special surgery,HSS)评分,并进行统计学分析。结果MB组与FB组手术时间及术中出血量比较差异均无统计学意义(P均>0.05)。术前、术后1周及术后1个月VAS评分差异均无统计学意义(P均>0.05),术前及术后1个月、3个月、6个月两组间ROM、HSS评分及术后6个月内并发症发病率差异均无统计学意义(P均>0.05)。结论MB和FB单髁置换术在膝骨性关节炎中短期疗效差异无统计学意义,MB单髁假体术后易出现假体脱位。展开更多
文摘BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.
文摘AIM To compare clinical outcomes of patients with and without preoperative genu recurvatum(GR) following mobile bearing unicompartmental knee arthroplasty(UKA). METHODS We prospectively followed 176 patients for at least 24 mo who had been treated by unilateral, minimally invasive, Oxford UKA. Patients with medial osteoarthritis(OA) knee and preoperative GR(Group Ⅰ) accounted for 18%(n = 32) and patients without preoperative GR(Group Ⅱ) accounted for the remaining 82%(n = 144). Knee score, pain scores, and functional scores were assessed for each patient and compared between the two groups. The incidence of postoperative GRand the postoperative hyperextension angles also were recorded and analyzed. RESULTS The pain score, knee score and functional score were not significantly different between the two groups. Similarly, the incidence of postoperative GR and the measured hyperextension angles were not significantly different between the two groups. The incidence of postoperative GR was 1/32(3.12%) in Group Ⅰ and 1/144(0.69%) in Group Ⅱ(P = 0.34). The mean postoperative hyperextension angles were 2.40°± 2.19°(range: 1°-7°) for Group Ⅰ and 1.57°± 3.51°(range: 1°-6°) for Group Ⅱ(P = 0.65).CONCLUSION Medial OA of the knee and concomitant GR is not a contraindication for the mobile bearing UKA.
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.
文摘Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA was confirmed by radiography in all patients, who were divided into three groups: exercise (n = 44), insole (n = 55), and brace (n = 19). Clinical knee functions and gait analyses were evaluated. Results: After 12 months, the clinical results for all groups had improved compared to pretreatment findings. Although the knee varus moment decreased and the gait speed increased when the insole was worn initially, the effects of the insole decreased at 6 and 12 months. In contrast, the knee varus moment decreased and the gait speed increased when the brace was initially fitted. The effects of the brace were maintained during the 12 months. Conclusions: The insole was effective for patients with Kellgren-Lawrence Grades II and III, and the knee brace was effective for patients with Grades III and IV conditions. Furthermore, the knee brace was more effective when worn for more than 6 months, while the effects of the insoles were not continuous.
文摘BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.
文摘The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage knee osteoarthritis (OA). Women presenting with knee pain were recruited into a cross-sectional correlation study (KOA, n = 9, age = 52 ± 4 yrs). Self report menstrual history, the Modified Baecke Questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subjective data were collected. A fasting blood sample (follicle stimulating hormone (FSH) and Tumor Necrosis Factor-α (TNF-α)), and urine catch (16α-hydroxyestrone and 2-hydroxyestrone) were collected. Gait analysis using an 8-camera motion analysis system assessed internal knee varus moment and foot progression angle. Pearson Product moments tested for associations between urinary 16α-hydroxyestrone and 2-hydroxyestrone, TNF-α, medial knee loading, and radiographic disease severity (Kellgren/Lawrence (K/L) radiographic score). Significant correlations were found within the hormonal biomarkers (r = 0.94, p p p = 0.31). No correlations were found for radiographic disease severity or TNF-α. The lack of association between hormonal and biomechanical variables could be due to large variability of the E2 metabolites seen in the menopause transition and the limited structural changes of initial staged knee OA.
文摘目的观察固定平台单髁置换加髁间窝成形术治疗中度固定屈曲畸形膝内侧间室骨关节炎的临床效果。方法选取2021年11月至2023年6月青岛市市立医院收治的合并有中度固定屈曲畸形的膝内侧间室骨关节炎患者50例,其中男24例,女26例,年龄64~75岁,平均(69.69±3.53)岁。按手术方式分为研究组(采用固定平台单髁置换加髁间窝成形术)和对照组(采用全膝关节表面置换术)各25例。对比两组手术前后Lysholm评分、美国特种外科医院(the hospital for special surgery,HSS)膝关节评分及疼痛视觉模拟评分(visual analogue scale,VAS),测量术前及术后12个月膝关节屈曲角度,对比两组伸膝角度改善情况。结果患者均获得12个月完整随访。术后2周、6周、3个月研究组Lysholm评分、HSS评分及VAS均优于对照组,差异有统计学意义(P<0.05);两组术后6个月、12个月Lysholm评分、HSS评分及VAS差异均无统计学意义(P>0.05);研究组术后12个月残留畸形角度大于对照组,差异有统计学意义(P<0.05)。结论对老年骨关节炎合并中度固定屈曲畸形患者采取固定平台单髁置换加髁间窝成形手术可以有效地减轻疼痛,改善膝关节功能,但对屈曲畸形的矫正能力小于全膝关节置换。
文摘目的观察活动平台与固定平台单髁置换术对膝骨性关节炎手术治疗的短期疗效。方法选取内侧单间室膝骨关节炎患者155例,均行人工单髁置换术,其中97例选择美国邦美Oxford第三代活动平台(mobilebearing,MB)单髁假体,58例选择德国LINK固定平台(fixed-bearing,FB)单髁假体。比较两组手术时间及术中出血量;术前及术后1周、1个月视觉模拟评分(VAS);术前及术后1个月、3个月、6个月膝关节活动度(range of motion,ROM)及美国特种外科医院(hospital for special surgery,HSS)评分,并进行统计学分析。结果MB组与FB组手术时间及术中出血量比较差异均无统计学意义(P均>0.05)。术前、术后1周及术后1个月VAS评分差异均无统计学意义(P均>0.05),术前及术后1个月、3个月、6个月两组间ROM、HSS评分及术后6个月内并发症发病率差异均无统计学意义(P均>0.05)。结论MB和FB单髁置换术在膝骨性关节炎中短期疗效差异无统计学意义,MB单髁假体术后易出现假体脱位。
