【摘要】 目的探讨微创单髁置换术治疗膝关节单间室骨性关节炎的临床疗效。方法 2011年10月~2013年3月,对51例(54膝)膝关节内侧间室骨性关节炎采用髓外定位法进行胫骨及股骨截骨,骨水泥固定OxfordⅢ单髁置换假体并植入移动半月板。观察切口长度,手术时间,手术前后血红蛋白下降量,术后直腿抬高时间,膝关节活动范围,术后髋膝踝角及并发症;采用Oxford评分法对术前、术后膝关节功能进行评估。结果 2例出现内衬脱位并发症进行翻修。无感染、下肢深静脉血栓、假体位置不良,假体松动等并发症。切口长度(6.6±0.8)cm(5.5~8 cm)。手术时间(59.9±6.6)min(50~80 min),术后3 d血红蛋白下降(13.5±5.0)g/L(7~28 g/L)。术后自主直腿抬高时间(3.4±1.6)d(1~8 d)。术后2~3 d行双下肢全长片检查,髋膝踝178.2°±2.6°(177°~183°)。术后无伸直受限,最大屈曲度121.3°±6.6°(110°~130°)。51例术后随访6~23个月,平均14.5月,无感染、下肢深静脉血栓、假体位置不良,假体松动等并发症。Oxford膝关节功能评分术前(24.6±1.9)分,术后末次随访(41.6±3.5)分,术前后比较有统计学差异(t=34.313,P=0.000)。结论微创单髁置换术治疗内侧间室骨性关节炎短期效果良好,中远期疗效需要进一步随访。更多还原

【Abstract】 Objective To explore the clinical efficacy of minimally invasive unicompartment knee arthroplasty(MI-UKA) for unicompartment knee osteoarthritis.Methods From October 2011 to March 2013,51 patients(54 knees) with unicompartment knee osteoarthritis were treated with MI-UKA.Tibia and femur osteotomy were performed via extramedullary alignment guidance,and then meniscal-bearing unicompartment prosthesis(Oxford Phase Ⅲ) was fixed with bone cement.Incision length,operative time,decreased hemoglobin values before and after surgery,time to straight leg raise,range of motion,postoperative hip-knee-ankle angle and complications were observed.The function results were assessed preoperatively and postoperatively by Oxford scores.Results Two patients underwent revision surgery due to bearing dislocation.The mean incision length was(6.6 ± 0.8) cm(range,5.5- 8 cm);the mean operative time was(59.9 ± 6.6) min(range,50- 80 min);the mean decreased hemoglobin values was(13.5 ± 5.0) g / L(range,7- 28 g / L) 72 h postoperatively;the mean time to straight leg raise was(3.4 ± 1.6) d(range,1- 8 d) after the surgery;and the mean postoperative hip-knee-ankle angle measured by lower limbs X-ray was 178.2° ± 2.6°(range,177°- 183°).The range of motion of knee reached a mean of 121.3°(range,110°- 130°).There was a statistical difference in Oxford scores between before and after the surgery [(24.6 ± 1.9) points vs.(41.6 ± 3.5) points,t = 34.313,P = 0.000].Fifty-one cases were followed up for 6 to 23 months(mean,14.5 months),and no infection,deep venous thrombosis or prosthesis mal-position and loosening were observed.Conclusion Minimally invasive unicompartment knee arthroplasty is an effective alternative for the treatment of unicompartment knee osteoarthritis,however,mid- and long-term studies are still required.更多还原