【摘要】 目的探讨股骨髓外定位微创单髁置换术的可行性及初步疗效。方法回顾性分析2009年1月～2010年1月采用MI-UKA治疗膝关节内侧间室骨性关节炎的患者11例(15膝),男8例,女3例;单侧7例,双侧4例;年龄为60～72岁,平均年龄65.2岁。观察切口大小、手术时间、出血量、引流量和并发症。采用HSS评分法对术前、术后膝关节功能进行评估,分析比较膝关节活动度,观察比较术前,术后下肢的力线(髋膝踝角)。结果切口大小平均7.2cm(6～8cm),术中出血平均50.8ml(50～80ml),手术时间平均115.0min(90～125min),术后引流量平均25.5ml(20～30ml)。所有患者均获得了完整的随访,11例(15膝)术后平均随访15个月(10～22个月)。末次随访患者膝关节内侧间室疼痛明显减轻,HSS评分和膝关节活动度明显增加,下肢力线内翻畸形明显减少。无感染、脂肪栓塞或下肢深静脉血栓,假体位置不良,脱位,假体松动等并发症。结论采用EFA行MI-UKA是一种可供选择的较好的办法,但中远期疗效尚需进一步随访。更多还原

【Abstract】 Objective To explore the feasibility and preliminary effect of minimally invasive unicondylar knee arthroplasty(MI-UKA)via extramedullary femoral alignment(EFA) guidance.Methods Between January 2009 and January 2010,11 consecutive patients(15 knees) with medial unicompartmental knee osteoarthritis were treated with MI-UKA,including eight males and three females.There were four cases of unilateral knee and seven cases of bilateral knees.The average age was 65.2 years(range,60~72 years).Incision,surgical time,blood loss,drainage and complications were measured.The pre-and post-operative functions of the knee were evaluated by HSS score system.The pre-and post-operative range of motion(ROM) and alignment of the lower limbs(hip-knee-ankle angle) were measured and compared.Results The mean length of incision was 7.2 cm(6 to 8 cm),the mean surgical time was 115.0min(90~125 min),the mean blood loss during operation was 50.8 ml(50~80 ml) and the mean drainage was 25.5 ml(20~30 ml).All cases were followed up for 15 months in average(10~22 months).At the latest follow-up,all cases achieved significant pain relief,improvement in HSS score and ROM,and correction of varus deformity.None of them had complications such as infection,fat embolism,deep vein thrombosis,mal-position of prosthesis,dislocation and loosening.Conclusions MI-UKA via EFA guide is an effective alternative for the treatment of medial compartmental knee osteoarthritis,however,mid-and long-term studies are required.更多还原