Labek G, Böhler N
Orthopädische Abteilung, Allgemeines Krankenhaus, Linz, Austria.
Orthopade. 2003 Jun;32(6):454-60. doi: 10.1007/s00132-003-0474-6.
Medial unicompartmental knee replacements have been used for more than 40 years. Due to increased experience in determining the indication for use and improvements in design of the prosthesis and tribology, the long-term results have now reached a high level. The advantages of these systems are less bone loss and better proprioception. The disadvantage is the risk of panarthrosis, which might be reduced by accurate indications for operations. Good indications are patients older than 60 years with normal weight and normal sports activity. Well-functioning collateral and cruciate ligaments are mandatory. Due to the fact that during implantation eversion of the patella is not necessary, a minimally invasive approach might be used. Overcorrection of the mechanical axis of the leg should be avoided. By observing these principles, very good long-term results can be achieved with medial unicompartmental arthroplasty. Better proprioception and better mobility of the knee are advantages of these implants compared to total knee arthroplasty. In the case of revision with a bicondylar implant, the situation is less complex compared to revisions after osteotomies or bicondylar replacements. Remobilization in this situation is shorter with better results compared to a revision with a bicondylar prosthesis.
内侧单髁膝关节置换术已应用40多年。由于在确定使用指征方面经验增加以及假体设计和摩擦学方面的改进，目前长期效果已达到较高水平。这些系统的优点是骨丢失少和本体感觉更好。缺点是全关节病的风险，通过准确的手术指征可能会降低这种风险。良好的指征是年龄大于60岁、体重正常且体育活动正常的患者。侧副韧带和交叉韧带功能良好是必需的。由于在植入过程中无需髌骨外翻，因此可以采用微创方法。应避免过度矫正下肢的机械轴。遵循这些原则，内侧单髁关节置换术可取得非常好的长期效果。与全膝关节置换术相比，这些植入物的优点是本体感觉更好且膝关节活动度更好。在使用双髁假体进行翻修的情况下，与截骨术或双髁置换术后的翻修相比，情况不太复杂。与使用双髁假体进行翻修相比，这种情况下的康复时间更短，效果更好。
