第三代牛津单髁系统在膝关节内侧间室骨性关节炎的应用

目的探讨牛津第三代单髁假体微创单髁置换术治疗膝关节内侧间室骨性关节炎的疗效与技术。方法回顾性分析2005年5月~2011年6月采用微创单髁置换术治疗100例膝关节内侧间室骨性关节炎患者的资料,对患者术前、术后膝关节疼痛及关节活动度进行评估(HSS评分法),并测量术后假体力线,分析假体设计、手术适应证的选择及手术技术。结果 100例术后平均随访36个月(12~75个月),末次随访时膝关节HSS评分和膝关节活动度明显增加,股骨假体力线平均为0.69°内旋±3.18°,0.83°伸直±3.63°,胫骨假体力线平均为0.12°内翻±0.80°,0.39°伸直±1.24°,无假体位置不良、脱位及假体松动等并发症。结论微创单髁置换术治疗膝关节内侧间室骨性关节炎具有很好的疗效,其关键在于手术适应证的选择和手术技术。

Clinical report of Phase III Oxford unicompartmental prostheses for medial compartmental osteoarthritis of the knee

Objective To explore the outcome and surgical technique of minimally invasive surgery unicondylar knee arthroplasty （UKA） for medial compartmental osteoarthritis of the knee. Methods 100 patients （100 knees） with medial compartmental osteoarthritis of knee treated by MIS-UKA from May 2005 to June 2011 were reviewed and anal- yzed. The pain and range of motion （ROM） of the knees were evaluated by HSS score system before and after MIS- UKA. Component alignment was measured and compared. Surgery indications and surgical technique of MIS-UKA were also summarized. Results 100 patients were followed up for a mean time of36 months （12-75months）. At the last follow up, all cases achieved significant relief of pain, improvement of HSS score and correction ofvarus deformity. The mean valgus/varus femoral component alignment was 0.69°varus±3.18°, The mean flexion/extension femoral component ali- gnment was 0.83°extension±3.63°, tibial component alignment was 0.12°varus±0.80°, the mean fiexion/extension femoral component alignment was 0.96°extension＋3.43, tibial component alignment was 0.39°extension±1.24°. All component size were fitness. Conclusion UKA is an effective method for medial compartmental osteoarthritis of the knee. Surgery indications and surgical technique are the key factors for the final results.