【摘要】 背景:单髁置换以其创伤小、康复快、花费少及本体感觉好等优点,越来越受到重视。而活动平台内侧单髁置换后,外侧间室和髌股间室骨关节炎中远期进展的研究较少。目的:评估活动平台内侧单髁置换后外侧和髌股间室骨性关节炎的进展情况。方法:回顾性分析了2011年1月至2016年1月在郑州大学第一附属医院骨科行活动平台单髁置换的95例患者资料。根据术前和末次随访膝关节X射线片,运用Kellgren-Lawrence分级评估外侧间室骨关节炎的进展情况,其中进展组32例,未进展组63例。运用Kellgren-Lawrence分级及是否有膝前痛症状评估髌股间室骨关节炎的进展情况,其中进展组41例,未进展组54例。比较骨关节炎进展组和未进展组的影像学和临床特征差异,分析术后效果与外侧和髌股间室骨关节炎进展的关系。结果与结论:(1)末次随访,与未进展组比较,外侧间室骨关节炎进展组患者美国特种外科医院评分降低(P <0.05),目测类比评分和人工关节被遗忘评分升高(P <0.05);(2)活动平台内侧单髁置换后外侧间室骨关节炎进展的发生率(33.7%)低于髌股间室骨关节炎进展的发生率(43.2%),外侧间室骨关节炎进展与髌股间室骨关节炎进展之间无显著相关性(P> 0.05);(3)术后随访5-10年,均未出现感染、聚乙烯垫片脱位、假体周围骨折等并发症;(4)活动平台内侧单髁置换后中远期效果主要受外侧间室骨关节炎进展影响,而不受髌股间室影响。更多还原

【Abstract】 BACKGROUND: Unicompartmental knee arthroplasty has attracted more and more attention because of its advantages, such as less trauma, faster recovery, less cost and better proprioception. However, there are few studies on the medium-and long-term development of lateral compartment and patellofemoral compartment osteoarthritis after mobile-bearing medial unicompartmental knee arthroplasty. OBJECTIVE: To evaluate the progression of posterolateral and patellofemoral osteoarthritis with mobile-bearing medial unicompartmental knee arthroplasty.METHODS: Totally 95 patients who underwent mobile-bearing medial unicompartmental knee arthroplasty in the Department of Orthopedics of First Affiliated Hospital of Zhengzhou University from January 2011 to January 2016 were retrospectively analyzed. Lateral compartment osteoarthritis was assessed byKellgren-Lawrence classification based on preoperative and final follow-up knee radiographs; there were advanced group(n=32) and non-advanced group(n=63). Patellofemoral compartment osteoarthritis was assessed by Kellgren-Lawrence classification; there were advanced group(n=41) and non-advanced group(n=54). Imaging and clinical features were compared in the advanced group and non-advanced group to analyze the relationship between the postoperative effect and the progression of lateral and patellofemoral compartment osteoarthritis. RESULTS AND CONCLUSION:(1) During final follow-up, compared with the non-advanced group, Hospital for Special Surgery scores were lower in the advanced group after lateral compartment osteoarthritis(P < 0.05); however, the visual analogue scale score and forgotten joint score were higher(P < 0.05).(2) The incidence of osteoarthritis progression in the lateral compartment(33.7%) was less than that in the patellofemoral compartment(43.2%) after mobilebearing medial Unicompartmental knee arthroplasty. There was no significant correlation between the progression of lateral compartment osteoarthritis and the progression of patellofemoral compartment osteoarthritis(P > 0.05).(3) After 5-10 years follow-up, there were no complications such as infection, polyethylene gasket dislocation or periprosthetic fracture.(4) The medium and long-term outcomes of the mobile-bearing medial unicompartmental knee arthroplasty were mainly affected by the progression of lateral compartment osteoarthritis, but not by the patellofemoral compartment.更多还原