【摘要】 目的探讨单髁置换术对膝前内侧骨关节炎合并髌股关节软骨损伤患者术后疗效的影响。方法选择自2016年3月至2018年8月期间,山西医科大学附属人民医院骨科关节微创病区完成的单髁置换病例67例,均因为膝前内侧骨关节炎就诊,所有病例均为单侧膝关节置换。其中男19例,女48例;年龄51～84岁,平均(64.67±8.37)岁;左膝41例,右膝26例;身体质量指数(body mass index,BMI)19.56～30.47kg/m~2,平均(25.27±2.56)kg/m~2;病程为0.5～20.0年,平均(5.08±4.83)年。术中通过Outerbridge分级记录观察到的髌股关节软骨损伤并进行分组,术后随访通过牛津膝关节评分(oxford knee score,OKS)、Lonner髌股关节评分评价术后疗效、髌股关节疼痛及功能改善情况,对术前及术后随访的评分分别进行统计学分析,以P<0.05为差异有统计学意义。结果所有患者均完成随访,随访时间12～25个月,平均(18.12±3.68)个月;OKS评分由术前平均(44.42±4.86)分降低至术后平均(21.46±4.64)分(P<0.01);Lonner疼痛评分由术前平均(29.91±2.48)分提高至术后平均(49.54±2.42)分(P<0.01);Lonner功能评分由术前平均(23.17±1.40)分提高至术后平均(38.89±1.41分)(P<0.01)。术中观察发现35膝(52%)合并内侧髌股关节软骨损伤病例,与无髌股关节软骨损伤病例(32膝)相比,术后髌股关节疼痛感及功能均得到改善,术后1、3、6、12个月OKS评分、Lonner疼痛与功能评分对比,差异均无统计学意义(P>0.05)。结论术中证实的内侧髌股关节软骨损伤并不影响Oxford单髁置换术短期疗效。单髁置换术可作为合并内侧髌股关节软骨损伤的膝前内侧骨关节炎患者的治疗方式。更多还原

【Abstract】 Objective To investigate the effect of single iliac replacement on the postoperative outcome of patients with anterior medial osteoarthritis complicated with patellofemoral articular cartilage injury.Methods From March 2016 to August 2018,67 cases of single sacral replacement were performed in our department.All cases were treated with unilateral knee osteoarthritis.All cases were unilateral knee replacement,including 19 males and 48 females;aged 51～84 years with an average of(64.67±8.37)years,including 41 cases of left knee,26 cases of right knee;BMI range from 19.56 to 30.47(mean:25.27±2.56).Duration of disease was 0.5～20.0 years(mean:5.08±4.83)years.Intraoperative patellofemoral articular cartilage injury was recorded by Outerbridge grading and grouped.The postoperative follow-up was evaluated by Oxford knee joint score(OKS score) and Lonner patellofemoral joint score to evaluate postoperative outcome and patellofemoral joint pain and functional improvement.The scores of preoperative and postoperative follow-up were statistically analyzed,and the difference was statistically significant,P<0.05.Results All patients were followed up for 12～25 months with an average of(18.12±3.68)months.The OKS score was reduced from the preoperative average(44.42±4.86) to the postoperative average(21.46±4.64),P<0.01;Lonner pain The score increased from the preoperative average(29.91±2.48) points to the postoperative average(49.54±2.42) points,P<0.01;the Lonner functional score increased from the preoperative average(23.17±1.40) points to the postoperative average(38.89±1.41 points),P<0.01;intraoperative observation revealed that 35 knees(52%) with medial patellofemoral articular cartilage injury,compared with no patellofemoral joint cartilage injury(32 knees),postoperative patellofemoral joint pain and function were obtained Improvement,comparison of OKS score,Lonner pain and functional scores at 1,3,6 and 12 months after surgery had no significant difference.Conclusion The intraoperative medial patellofemoral articular cartilage injury does not affect the short-term efficacy of Oxford monoterpene replacement.UKA can be used as a treatment for patients with anterior knee osteoarthritis with medial patellofemoral articular cartilage injury.更多还原