【作者】 王斌；

【导师】 吴立东；

【作者基本信息】 浙江大学 ， 外科学（专业学位）， 2013， 硕士

【摘要】 目的：对膝关节单髁置换(unicompartment knee arthroplasty, UKA)治疗膝关节病变的近期疗效进行分析,并探讨其手术适应证、手术技巧等。方法：回访从2011年2月至2012年7月在我院骨科关节病区行膝关节单髁置换术治疗的25例(26膝)膝关节病变患者,其中男9例9膝,女16例17膝；全部病例均为内侧髁置换。年龄43-82岁,平均63.3岁；体重44～78kg,平均60.7kg；术后随访8～25月,平均17.8月。所有患者术前行膝关节正侧位X线片及下肢全长片,诊断均为内侧间室骨关节炎。分别测量术前及术后胫股角(femorotibial angle, FTA).膝关节最大活动度,并进行膝关节评分(American knee society knee score,简称KSS评分)。结果：随访的25例(26膝)患者术前FTA平均为181.3°,术后平均为176.1°,与术前相比,差异有统计学意义(P<0.05)；膝关节最大活动度术前平均为106.3°,术后为123.1°,差异有统计学意义(P<0.05)；KSS临床评分由术前平均61.8分提高至术后平均94.5分,KSS功能评分由术前43.8分提高至术后平均83.5分。KSS评分包括临床和功能评分在统计学上均具有显著性差异(P<0.05)。结论：对于膝关节单间室病变的患者,膝关节单髁置换近期疗效满意,相比于全膝关节置换术(total knee arthroplasty, TKA)手术创伤小、术后恢复快；目前对UKA的手术适应证没有完全统一的认识,随着技术的进步适应证逐渐放宽,同时对术中的技术具有很高的要求。更多还原

【Abstract】 Objective To report the short-term results of unicompartment knee arthroplasty(UKA), and to detail possible factors of success including indications and surgical techniques.Methods Between February2011and July2012,25patients (26knees) were chosen that had been performed medial UKA. There were9males (9knees) and16females (17knees) with an average age of63.3years (range,43-82years). The patients’ mean weight was60.7kg (range,44-78kg). The25patients studied had an average follow-up period of17.8months (range,8-25months). All the patients had a complete radiological evaluation and the preoperative diagnosis was osteoarthritis. Patient evaluation consisted of femorotibial angle (FTA), range of motion and American knee society knee score(KSS knee score criterion) before surgery and at the last follow-up.Results The mean FTA improved from a preoperative mean of181.3degrees to176.1degrees postoperatively on the UKA side. The mean range of motion improved from106.3degrees to123.1degrees. The average American Knee Society knee score varied from61.8before surgery to94.5and the function score from43.8to83.5.There were significant difference of FTA, range of motion and KSS knee score between pre-operation and post-operation.Conclusions The short-term result of UKA is satisfactory. Minimally invasive UKA can make recovery rapid with a short hospital stay. Surgeons are broadening their indications for this procedure. The procedure remains technically demanding and unforgiving.更多还原