应用Oxford单髁置换术治疗年轻膝内侧单间室骨关节炎患者的早期疗效

目的探讨应用Oxford单髁置换术治疗55岁及以下膝内侧单间室骨关节炎患者的早期疗效。方法回顾性分析2014年1月至2016年12月在北京积水潭医院矫形骨科行Oxford活动平台单髁置换术治疗的47例(56膝)55岁及以下膝内侧单间室骨关节炎患者的病历资料。术前及末次随访记录患者的牛津大学膝关节评分(OKS)、视觉模拟评分(VAS)、膝关节活动度(ROM)及机械轴股骨胫骨角(mFTA),并分析患者术后并发症发生率及假体生存率。结果手术年龄为(52.77±2.28)岁。随访时间为(42.16±9.60)个月。ROM由术前的(114.02±5.75)°提高至术后的(120.35±8.63)°,差异有统计学意义(P<0.05)。VAS评分由术前的(6.14±0.86)分降低至术后的(1.18±1.38)分,差异有统计学意义(P<0.05)。mFTA角由术前的(7.14±2.66)°改善至术后的(4.10±2.39)°,差异有统计学意义(P<0.001),且无膝关节内翻过度矫正。OKS评分由术前的(20.04±3.88)分提高至术后的(42.07±4.58)分,差异有统计学意义(P<0.001),优良率为91.1%。5例患者术后残留持续疼痛。随访期间,未发生其他严重并发症,假体生存率为100%。结论Oxford单髁置换术可显著改善年轻膝内侧单间室骨关节炎患者的临床症状和膝关节功能,早期疗效满意。残留疼痛是Oxford单髁置换术后最常见的并发症。

Early-term outcomes of Oxford unicompartmental knee arthroplasty in young patients with medial compartmental knee osteoarthritis

Objective To evaluate the early-term outcomes of Oxford unicompartmental knee arthroplasty(UKA)in young active patients(≤55 years)with medial compartmental knee osteoarthritis.Methods From January 2014 to December 2016,47 patients(56 knees)no more than 55 years of age were evaluated with a minimum follow-up of 2 years after Oxford UKA in Department of Orthopaedic Surgery,Beijing Jishuitan Hospital.All the cases were assessed with the Oxford knee score(OKS)and the visual analogue scale(VAS),range of motion(ROM),and mechanical femoral tibial angle(mFTA)before the surgery and at the last follow-up.Complications and implant survival were also evaluated.Results The mean age was(52.77±2.28)years(range,47-55 years).The mean follow-up period was(42.16±9.60)months(range,48-60 months).The knee ROM was(114.02±5.75)°pre-operatively,and was significantly increased to(120.35±8.63)°post-operatively(P<0.05).The VAS score was(6.14±0.86)pre-operatively,and was significantly decreased to(1.18±1.38)post-operatively(P<0.05).The mFTA was(7.14±2.66)°pre-operatively,and was significantly increased to(4.10±2.39)°post-operatively(P<0.05).The OKS was(20.04±3.88)pre-operatively,and was increased to(42.07±4.58)post-operatively,with 91.1%of the knees having an excellent or good result.Persist residual pain was found in 5 knees(8.9%)post-operatively.No other complications were found during followed-up time.The implant survival rate was 100%.Conclusion The Oxford medial UKA was reliable and effective in young active patients providing good clinical results and survival rate at early-term follow-up.Rusidual pain is the most common complication after surgery.