作　　者： (邬波）; (柳椰）; (杜明昌）; (马旭）; (翟良全）; (谭成波）; (杨政博）; (付侚）;

机构地区： 沈阳市骨科医院关节外科,沈阳110044

出　　处： 《中国骨与关节外科》 2017年第2期123-125,131,共4页

摘　　要： 背景:骨关节炎是影响广大老年患者活动能力的常见疾病,对于这类患者,膝关节单髁置换具有创伤小、恢复快、并发症少、保留膝关节正常本体感觉等诸多优点。目前国内关于膝关节单髁置换治疗膝内侧间室骨关节炎的报道不多。目的:评估单髁置换术治疗膝关节内侧间室骨关节炎的效果。方法:回顾分析2014年3月至2015年3月我院应用单髁置换治疗的膝关节内侧间室病变37例患者(47膝)的临床资料,记录手术时间、术中出血量、术后引流量及隐性出血量。对患者术前、术后的关节活动度、膝关节疼痛(VAS评分)及膝关节功能评分(HSS评分)进行评估。并于末次随访时摄膝关节负重正侧位X线片,判断假体是否沉降或松动。结果:所有37例患者均顺利完成手术,平均手术时间为(68.6±17.4)min,平均术中出血量为(98.4±16.8)ml,平均术后引流量为(153.2±37.5)ml,平均隐性出血量为(104.3±21.7)ml。术后HSS膝关节评分及关节活动度均较术前提高,VAS评分较术前降低,且差异具有统计学意义(P<0.05)。末次随访X线片可见假体位置好。结论:膝关节单髁置换治疗膝内侧间室骨关节炎的疗效可靠,其创伤小、出血少,在严格把握手术适应证的条件下,是治疗膝内侧间室骨关节炎的有效方法。 Background：Osteoarthritis is a common disease affecting the motor function of the elderly patients. Unicom-partmental knee arthroplasty （UKA） has been becoming popular for this disease. It has many advantages, such as small trauma, rapid recovery, low incidence of complication and retaining proprioception. However, there are few reports on the treatment of of medial compartment arthritis by UKA. Objective：To evaluate the clinical outcome of UKA in the treatment of medial compartment arthritis. Methods：Clinical data of 37 patients （47 knees） who underwent UKA from March 2014 to March 2015 in our hospital were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative drain-age volume and hidden blood loss were recorded. The visual analogue scale （VAS）, Hospital for Special Surgery （HSS） score and knee joint range of motion were also recorded before and after surgery. Imaging examination was performed at the final follow-up to detecte whether the prosthesis loosened or not. Results：The operation was successfully performed in all the 37 patients. The average operation time was （68.6±17.4） min. The average intraoperative blood loss was （98.4±16.8） ml. The average postoperative drainage volume was （153.2±37.5） ml. The average hidden blood loss was （104.3±21.7） ml. Compared with preoperative ones, postoperative HSS score and knee joint range of motion were significantly increased, while VAS score was significantly decreased （P〈0.05）. X ray showed that no breakage or loosening at the final follow-up. Conclusions：UKA is an effective procedure for medial compartment arthritis with less trauma and bleeding. It is considered to be a preferred treatment for medial compartment arthritis under strict choice of surgical indications.

关 键 词： 单髁置换 膝关节 骨关节炎