固定平台单髁置换治疗外侧单间室膝骨关节炎的早期疗效

目的探讨外侧固定平台单髁关节置换术治疗外侧单间隙骨关节炎手术策略及早期疗效。 方法选取2016年8月至2017年1月在济南军区总医院骨病科行膝关节外侧单髁关节置换术病人11人，纳入标准：外侧单间隙骨关节炎；无关节外畸形，不伴或伴轻度膝外翻畸形；前后交叉韧带及内外侧副韧带完整；共11膝，男性5人，女性6人。平均年龄(57±6)岁，身体质量指数为(29.5±2.7)，术前行膝关节负重正侧位、双下肢全长正位及髌骨轴位X线片检查。行外侧单髁关节置换术，手术入路选择膝关节正中切口，沿髌骨外缘切开关节囊，清理外侧间室，胫骨行髓外定位进行垂直及水平截骨，股骨切除软骨至软骨下骨，调和骨水泥，安放假体。应用牛津大学膝关节评分系统(OKS)及美国膝关节协会评分系统(KSS)评价术后功能改善情况。采用Mann-Whitney U检验进行统计学分析。 结果11名病人均获得随访，随访时间平均(5.0±1.1)月，术后OKS及KSS评分均得到明显改善，OKS评分(Z ＝－11.345，P <0.05)和KSS评分(Z ＝－15.542，P<0.05)差异具有统计学意义，膝关节功能良好，术后病人满意度改善。随访终点均未发现并发症。 结论外侧单髁关节置换术治疗外侧单间隙骨关节炎是1种有效的保膝治疗方式，可以有效保存膝关节韧带，减少截骨量，患者术后膝关节功能良好。

Early effects of fixed bearing unicompartmental knee arthroplasty for lateral unicompartment osteoarthritis

ObjectiveTo investigate surgical techniques and the early effects of fixed bearing lateral unicompartmental knee arthroplasty in treatment of isolated lateral tibiofemoral osteoarthritis. MethodsEleven cases of osteoarthritis were followed up including five males and six females. Inclusion criteria: lateral unicompartmental osteoarthritis; without extra knee deformity; integrity of anterior and posterior cruciate ligaments and medial and lateral collateral ligaments. The average age was (57±6)years and body mass index(BMI)was(29.5±2.7). Every case adopted weight-bearing X-ray, skyline patellofemoral radiographs and full-length lower limbs X-ray before the surgery. Surgical technique : standard parapatellar approach was used, the lateral compartment was cleaned up. The tibial cut was located by outside the medullary to make vertical and horizontal osteotomy. The cartilage of femoral part was removed, the prosthesis was installed with bone cement. Evaluation of the treatment was performed by Oxford knee score (OKS)and Knee Society score (KSS). Statistical analysis was done with Mann-Whitney U test. ResultsAll the cases were followed up for (5.0±1.1)months.The OKS and KSS scores improved significantly after the surgery(OKS: Z=-11.345, KSS: Z=-15.542; both P<0.05). No complication was found at the end of follow-up. ConclusionThe treatment of fixed bearing lateral unicompartmental knee arthroplasty is effective, which can preserve the ligament of the knee, reduce bone mass of osteotomy, and the knee function is good.