小切口单髁置换术治疗膝关节内侧间室骨关节炎94膝的中短期疗效研究Minimally invasive unicompartmental knee arthroplasty for knee osteoarthritis
郭万首;张启栋;刘朝晖;程立明;李子荣;
摘要(Abstract):
[目的]探讨小切口单髁置换术治疗膝关节内侧间室骨性关节炎的中短期疗效与手术技术。[方法]回顾性分析本院2003年1月~2010年6月收治的87例(94膝)经小切口单髁置换术治疗的膝关节内侧间室骨性关节炎患者的资料。对患者膝关节疼痛VAS评分、关节活动度、膝关节HSS评分、关节力线等进行评估分析,分析单髁关节置换临床效果、遇到的问题及应对方法。[结果]术后平均随访3.4年(6个月~7年),返修2例,无感染、深静脉血栓、假体脱位等,HSS评分由术前61.05分增至92.67分,优良率达92%。VAS评分由术前6.46分降至2.80分。术后疼痛缓解率94%。膝屈曲度平均达127.53°。术后力线平均内翻2°。[结论]小切口单髁置换术治疗膝关节内侧间室骨性关节炎中短期疗效满意,具有创伤小、恢复快、症状改善明显、术后功能良好等特点。
关键词(KeyWords): 单髁置换术;膝骨性关节炎;内翻畸形
基金项目(Foundation):
作者(Author): 郭万首;张启栋;刘朝晖;程立明;李子荣;
Email:
DOI:
参考文献(References):
- [1]Zhang QD,Guo WS,Zhang Q,et al.Comparison of unicompartmentalknee arthroplasty and total knee arthroplasty in the treatment of uni-compartmental osteoarthritis:a meta-analysis[J].Curr Orthop Prac,2010,5:497-503.
- [2]Kozinn SC,Scott R.Current concepts review.Unicompartmental knee-arthroplasty[J].J Bone Joint Surg Am,1989,1:145-150.
- [3]张启栋,郭万首,刘朝晖,等.胫骨高位截骨与单髁关节置换治疗膝关节单间室骨关节炎的荟萃分析[J].中华医学杂志,2009,39:2768-2772.
- [4]Berger RA,Meneghini RM.Results of unicompartmental knee arthro-plasty at a minimum of ten years of follow-up[J].J Bone Joint SurgAm,2005,5:999-1006.
- [5]Newman J,Pydisetty RV,Ackroyd C.Unicompartmental or total kneereplacement:the 15-year results of a prospective randomised con-trolled trial[J].J Bone Joint Surg Br,2009,1:52-57.
- [6]Price A J,Waite J C,Svard U.Long-term clinical results of the medi-al Oxford unicompartmental knee arthroplasty.[J].Clin Orthop,2005,435:171-180.
- [7]Riddle DL,Jiranek WA,Mcglynn FJ.Yearly incidence of unicompart-mental knee arthroplasty in the United States[J].J Arthroplasty,2008,3:408-412.
- [8]Griffin T,Rowden N,Morgan D,et al.Unicompartmental knee arthro-plasty for the treatment of unicompartmental osteoarthritis:a systematicstudy[J].ANZ J Surg,2007,4:214-221.
- [9]Hernigou P,Medevirlle D,Debeyer J,et al.Proximal tibial osteotomy-for osteoarthritis with varus deformity.A ten to thirteen-year follow-up study[J].J Bone Joint Surg Am,1987,3:332-353.
- [10]Katz M M,Hungerford D S,Krackow K A,et al.Results of total kneearthroplasty after failed proximal tibial osteotomy for osteoarthritis[J].J Bone Joint Surg Am,1987,2:225-233.
- [11]Laurencin CT,Zelicof SB,Scott RD,et al.Unicompartmental versus to-tal knee arthroplasty in the same patient.A comparative study[J].Clin Orthop,1991,273:151-156.
- [12]Stukenborg-Colsman C,Wirth CJ,Lazovic D,et al.High tibial osteot-omy versus unicompartmental joint replacement in unicompartmentalknee joint osteoarthritis:7-10-year follow-up prospective random-ised study[J].Knee,2001,3:187-194.
- [13]Kennedy WR,White RP.Unicompartmental arthroplasty of the knee.Postoperative alignment and its influence on overall results[J].ClinOrthop,1985,221:178-285.
- [14]Perkins TR,Gunckle W.Unicompartmental knee arthroplasty:3-to10-year results in a community hospital setting[J].J Arthroplasty,2002,173:293-297.
- [15]Hernigou P,Deschamps G.Posterior slope of the tibial implant and theoutcome of unicompartmental knee arthroplasty[J].J Bone Joint SurgAm,2004,3:506-511.