膝关节单髁置换中期随访报告

目的探讨膝关节单髁置换的技术特点和临床疗效。方法回顾性分析2005年1月至2009年5月，在本组行单髁置换的62例患者（85膝），单侧39膝，双侧23例（46膝）；其中男8例10膝，女54例75膝。男：女为1：7．5；年龄44～78岁，平均63岁；内侧单髁置换79膝，外单髁置换6膝，所有患者均使用LINK单髁假体（WMdemar Link GmbH＆Co），将术前及最后一次复查KSS评分分值及关节活动度对比，评定膝关节功能。术后定期拍x线平片评估假体位置及未置换间室退变情况。结果获得随访的患者62例85膝，平均随访时间65．8个月（48～99个月）。膝关节KSS评分：术前（58．22±20．07）分，术后最后一次随访（81．24±17．96）分（P〈0．01）。关节活动度：术前（126．73°±7．53°），术后最后一次随访（124．65°±8．65°）（P〉0．05）。术后首次与最后一次随访X线平片检查，未置换间室退变进展不明显。5例患者6膝分别在术后11—42个月出现胫骨部分假体松动，3膝做全膝翻修术。另2例（3膝）患者服用镇痛药，可行走及坚持日常活动，目前在随访中。结论单髁置换可以获得良好的关节功能，在一定程度上减缓了膝关节退变进展速度，但胫骨假体松动有较高的发病率，需要高度重视。

Midterm follow-up report on unicondylar knee arthroplasty

Objective To evaluate the technical characteristics and the clinical efficacy of unicondylar knee arthroplasty （UKA）. Methods 62 patients with 85 knees （39 patients of unilateral knee, 23 patients of bilateral knees） who underwent UKA at our hospital from January 2005 to May 2009 had been reviewed. There were eight males with 10 knees and 54 females with 75 knees. The sex ratio was 7.5 females per male. Their age ranged from 44 to 78 years with an average of 63 years. There were 79 cases of medial unicondylar knee arthroplasty and six lateral unicondylar knee arthroplasty cases. Unicompartmental prostheses from Waldemar Link GmbH ＆ Co were used in all cases. The KSS knee scores and ranges of joint motion before operation and at the last review after operation were compared to evaluate the function of the knee joint. All patients underwent X-ray examination after operation to observe the prosthesis location and changes of non-replaced compartments. Results 62 patients with 85 knees were followed up for 65. 8 months after operation （ ranged from 48 to 99 months）. Their KSS knee scores improved from （58.22 ±20. 07） to （81.24 ± 17.96） （P 〈0. 01 ）. The range of knee motion averaged in （126. 73 ±7.53） degrees before operation and （124. 65 ± 8. 65） at the last review after operation （P 〉 0. 05 ）. The first and last time X-ray examinations after operation showed that the development of non- replaced compartments was not obvious. Five patients with six knees had looseness in part of the tibial prosthesis between 11 to 42 months after operation. Three knees had total knee revision surgery; the other two patients with three knees took analgesics and were able to walk and do daily activities. They are under our follow-up at present. Conclusion Unicondylar knee arthroplasty achieves good joint functions and, to some extent, slows down the progression rate of knee degeneration. Nonetheless, the morbidity of prosthesis looseness in the tibia is noticeably high and must be paid attention to.