Liu Yu-Jie, Li Zhong-Li, Wang Zhi-Gang, Xue Jing, Zhou Mi, Cai Xu, Wei Min, Wang Yan
Department of Orthopedic Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2007 Mar 6;87(9):590-3.
To discuss the value of arthroscopic techniques in determining the indications of unicondylar arthroplasty.
Twenty-four patients with knee osteoarthritis, 14 males and 19 females, aged 63 (49 - 74), who were scheduled to undergo unicondylar arthroplasty were arthroscopically evaluated at the beginning of surgery. Arthroscopy showed injury of degree IV in the tibial and femoral cartilages in the medial compartment, severe abrasion of meniscus, and exposure of subchondral bone. Unicondylar arthroplasty was given up on 8 cases because of cartilage injuries in the lateral compartment, while the surgery was performed on the other 16 cases. All cases underwent synovium debridement, 5 of which underwent meniscus repair or partial meniscectomy in the lateral compartment, 4 underwent patellar reticulum releasing and peri-patellar denervation, 3 cases underwent synovium plica resection, and 4 cases had their loose bodies removed. Follow-up was conducted on 16 cases for 14 months on average.
The average Lysholm score of the patients was 67.5 preoperatively and became 94 postoperatively. After operation, the symptoms of locking and pain were relieved. The functional evaluation result was excellent in 12 cases, good in 2, and fair in 2.
Arthroscopic evaluation of intra-articular structures is valuable in determination of unicondylar arthroplasty indications. Arthroscopic procedures are valuable in minimizing preoperative symptoms.
探讨关节镜技术在确定单髁置换术适应证方面的价值。
24例膝关节骨关节炎患者,男14例,女19例,年龄63岁(49 - 74岁),拟行单髁置换术,在手术开始时进行关节镜评估。关节镜检查显示内侧间室胫骨和股骨软骨Ⅳ度损伤,半月板重度磨损,软骨下骨暴露。8例因外侧间室软骨损伤放弃单髁置换术,其余16例进行手术。所有病例均行滑膜清理术,其中5例在外侧间室行半月板修复或部分半月板切除术,4例行髌腱松解及髌周去神经术,3例行滑膜皱襞切除术,4例取出游离体。对16例患者进行随访,平均随访14个月。
患者术前Lysholm评分平均为67.5分,术后为94分。术后,交锁和疼痛症状缓解。功能评估结果为优12例,良2例,可2例。
关节镜评估关节内结构对确定单髁置换术适应证有价值。关节镜手术在减轻术前症状方面有价值。