膝关节单髁置换术早中期并发症分析

1目的探讨膝关节单髁置换术（UKA）早中期并发症的原因及防治方法。方法回顾性分析2003～2013年本组行UKA共217膝的临床结果，对早中期并发症进行分析。男46膝，女171膝，平均年龄65．3岁。术前诊断为膝关节骨关节炎201膝，骨坏死16膝。结果术后平均随访5．8年，患者满意率87％，疼痛缓解率93％，膝活动度123°，HSS评分92分。所有病例无临床深静脉血栓和肺栓塞发生，无手术死亡病例。术后全膝关节置换翻修3例：1例假体松动、1例假体周围感染、1例对侧间室骨关节炎。Oxford半月板衬垫脱位2例，手术更换大号半月板衬垫。另有对侧间室骨关节炎1例未进行翻修。结论膝关节UKA治疗膝关节内侧间室病变中短期疗效满意，但存在特有并发症，应严格手术适应证、掌握手术操作原则及技术，完善围手术期处理，减少并发症的发生。

Analysis of early and mid-term complications in unicompartmental knee arthroplasty

Objective To examine the clinical results and complications of unicompartmental knee arthroplasty. Methods 217 knees of unicompartmental knee arthroplasties which were performed between 2003 and 2013, were reviewed. The mean age was 65.3 years and the mean follow-up period was 5.8 years. The preoperative diagnosis was osteoarthritis in 201 knees, osteonecrosis in 16 knees. Results Pain relief rate was 93%. The mean post-operative range of motion （ROM） of the knees was 123°. HSS score increased from 62 to 92. Three knees were revised to total knee arthroplasty： one was aseptic loosening, one was periprosthetic infection, and the other was degeneration in the nonresurfaeed compartments. Oxford bearing dislocation was encountered in two cases. No patients had symptomatic venous thromboembolism or pulmonary embolism. Conclusion Unicompartmental knee arthroplasty provided rapid recovery, good pain relief and excellent function. Complications encountered in the midterm results suggest that patient selection and technical skill are critical to excellent outcome.