膝关节单室置换的近期疗效

目的 探讨Oxford Ⅲ代假体行单室置换治疗膝关节内侧室骨关节炎的适应证和近期疗效.方法 2006年5月至2008年5月,采用Oxford Ⅲ代假体行膝关节单室置换患者21例30膝,男9例12膝,女12例18膝;年龄46～76岁,平均(61.4±7.3)岁;体重68～89 kg,平均(75.8±6.1)kg;身高1.157～1.75 m,平均(1.65±0.06)m;体重指数(BMI)24.73～31.64 kg/m2,平均(27.92±2.12)kg/m2.术前膝关节活动范围为122.1°±4.4°.比较手术前、后X线片,并采用配对t检验对手术前、后KSS临床及功能评分、WOMAC评分以及膝关节活动范围等计量数据进行统计学分析.结果 患者平均手术时间(83.0±12.9)min,平均住院时间(9.3±2.0)d.术后无一例患者发生感染、血栓形成和活动半月板脱位等并发症.21例患者均获得随访,随访时间12～36个月,平均17个月.冠状位胫股外侧角由术前平均182.0°±4.3°减至术后177.0°±3.5°;KSS临床和功能评分分别由术前平均(44.0±3.7)分和(54.0±5.1)分增至术后(93.0±3.2)分和(92.0±2.4)分.WOMAC评分由术前平均(48.0±4.2)分减至术后(14.0±2.5)分.结论 Oxford Ⅲ代假体行单窜置换的近期疗效理想,是治疗膝关节内侧室骨关节炎的一个良好手术选择.

Short-term clinical outcomes of unicompartmental knee replacement

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.