Deshmukh Rahul V, Scott Richard D
Harvard Combined Orthpaedic Surgery, Boston, MA, USA.
Clin Orthop Relat Res. 2002 Nov(404):108-12. doi: 10.1097/00003086-200211000-00019.
Unicompartmental knee arthroplasty has been a controversial operation for the past 3 decades. Many surgeons in the 1980s and 1990s found little or no indication for the procedure. Others were enthusiastic for its use in selected patients with osteoarthritis who had unicompartmental disease. Initially, unicompartmental knee arthroplasty was thought to be appropriate for the elderly patient who was sedentary. With the advent of minimally invasive techniques, indications have expanded to include its use in younger patients (especially females) as an alternative to osteotomy or tricompartmental knee arthroplasty. Advantages over osteotomy include higher initial success, greater longevity, and fewer early complications. If done conservatively, salvage is not difficult. The extent of safe postoperative activity levels has yet to be established. Failure rates seem to be higher in heavy active males. A metallic interposition hemiarthroplasty in the form of a McKeever or Macintosh prosthesis has been available for 50 years as a unicompartmental arthroplasty, but with limited use. It still may have a role in selected patients as a conservative temporizing procedure.
在过去三十年里，单髁膝关节置换术一直是一种存在争议的手术。20世纪80年代和90年代的许多外科医生几乎找不到该手术的适应证或认为根本没有适应证。另一些人则热衷于将其用于患有单髁疾病的特定骨关节炎患者。最初，单髁膝关节置换术被认为适用于久坐不动的老年患者。随着微创技术的出现，适应证已扩大到包括在年轻患者（尤其是女性）中使用，作为截骨术或全髁膝关节置换术的替代方法。与截骨术相比，其优点包括更高的初始成功率、更长的使用寿命和更少的早期并发症。如果操作保守，补救并不困难。术后安全活动水平的范围尚未确定。在活动量大的男性中，失败率似乎更高。作为单髁置换术的一种，以麦基弗或麦金托什假体形式存在的金属间置半关节置换术已有50年历史，但使用有限。在特定患者中，它作为一种保守的临时手术可能仍有作用。
