固定平台与活动平台单髁置换治疗膝关节单间室骨性关节炎的病例对照研究

目的:分析固定平台与活动平台单髁置换治疗膝关节单间室骨性关节炎的早期临床疗效。方法 :选取2013年1月至2014年12月关节骨病专科门诊就诊并收治住院手术的86例(92膝)膝关节单间室(内侧)骨性关节炎病例,分成两组:一组为固定平台(Link)组,共42例,其中男18例,女24例,选用固定平台假体行单髁置换手术;另一组为活动平台(Oxford)组,共44例,其中男20例,女24例,选用活动平台假体行单髁置换手术。由同一组医生完成手术,分别记录两组手术操作时间,术中失血量,术前与末次随访的膝关节活动度,进行膝关节美国特种外科医院(Hospital for Special Surgery,HSS)评分,膝关节协会评分(Knee Society Score,KSS)并完成临床随访。结果:两组患者术后随访时间8～26(18.20±4.23)个月。临床随访过程发现在固定平台组术后1年出现1例假体周围骨折,活动平台组发现1例垫片脱位。所有患者未出现伤口愈合不良及假体周围感染、假体松动等并发症。固定平台组手术耗时(90.05±6.59) min,失血量(53.76±6.04) ml;活动平台组手术...

A case-control study of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee

Objective: To compare and analyze the early clinical outcomes of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee.Methods: From January 2013 to December 2014,86 cases(92 knees) of knee osteoarthritis with single compartment (medial) were randomly divided into two groups. One group consisted of 42 patients,including 18 males and 24 females,underwent unicompartmental knee arthroplasty with fixed platform prosthesis; the other group consisted of 44 patients,including 20 males and 24 females,underwent unicompartmental knee arthroplasty with mobile platform prosthesis. The surgery was performed by the same group of doctors. The operation time,blood loss,ROM,KSS and HSS scores of knee joint before and after surgery were recorded and the clinical follow-up was completed.Results: The follow-up duration of the two groups ranged from 8 to 26 months,with an average of(18.20±4.23) months. During the follow-up period,the periprosthetic fracture was found in 1 patient in the fixed platform group 1 year after operation,and polyethylene liner dislocation was found in 1 patient in the mobile platform group. No complications such as poor wound healing,periprosthetic infection or sterile prothesis loosening were found in all cases. In the fixed platform group,the operation time was (90.05±6.59) minutes and the blood loss was (53.76±6.04) ml. In the mobile platform group,the operation time was(90.73±6.74) minutes and the blood loss was(54.34±6.27) ml. In the fixed platform group,the ROM of knee increased from preoperative(94.52±4.54) degree to postoperative(104.64±4.42) degree. In the mobile platform group,the ROM of knee increased from preoperative (95.05±4.87) degree to postoperative (105.07±4.33) degree. In the fixed platform group,the KSS score increased from preoperative 48.69±5.68 to postoperative 83.55±5.37. In the mobile platform group,the KSS score increased from preoperative 49.39±5.68 to postoperative 84.11±6.14. In the fixed platform group,the HSS score increased from preoperative 45.45±3.62 to postoperative 84.55±6.08. In the mobile platform group,the HSS score increased from preoperative 45.93±4.01 to postoperative 85.16±6.30. There was no significant difference between the two groups.Conclusion: There is no significant difference in the early outcome of unicondylar prosthesis with fixed and mobile platforms in the treatment of single compartmental osteoarthritis of knee. The long-term complications and revision rates of the two prostheses need further multi-center and large-sample clinical study.