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[牛津三期单髁膝关节置换术治疗内侧骨关节炎的中期结果]

[Midterm results of Oxford phase 3 unicondylar knee arthroplasty for medial osteoarthritis].

作者信息

Aslan Hakan, Ersan Onder, Baz Ali Bülent, Duman Evrim, Aydin Erbil, Ateş Yalim

机构信息

Department of Orthopedics and Traumatology (1. Ortopedi ve Travmatoloji Kliniği), Ankara Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2007 Nov-Dec;41(5):367-72.

Abstract

OBJECTIVES

We evaluated midterm results of Oxford phase 3 unicondylar knee arthroplasty (UKA) in patients with medial osteoarthritis.

METHODS

Twenty-seven patients (24 females, 3 males; mean age 57 years; range 47 to 73 years) underwent Oxford phase 3 UKA with the diagnosis of medial knee osteoarthritis. All patients had primary osteoarthritis but one with spontaneous osteonecrosis. Nine knees were Ahlback grade 2, and 18 knees were grade 3. All femoral and tibial components were cemented and mobile tibial polyethylene inserts were used in all the patients. Pre- and postoperative evaluations were made using the Knee Society clinical rating system. The mean follow-up was 28 months (range 24 to 36 months).

RESULTS

Compared to the preoperative values, significant improvements were obtained in the following at final follow-up (p<0.05): knee flexion (106.4 degrees and 117.4 degrees , respectively), tibiofemoral angle (7 degrees varus and 1 degrees valgus), knee score (47.5 and 78.9), and functional knee score (48.7 and 83.6). Only two patients needed blood transfusion. No major complications occurred including infection, deep vein thrombosis, pulmonary emboli, and neurovascular injury. Two patients underwent revision surgery at postoperative 8 and 10 months, respectively, because of progressive collapse of the tibial plateau. Knee Society clinical scores were excellent or good in 21 (77.8%), moderate in four (14.8%), and poor in two (7.4%) patients. The corresponding figures for functional results were 23 (85.2%), 2 (7.4%), and 2 (7.4%).

CONCLUSION

Our results demonstrate that Oxford phase 3 UKA is effective with considerable success in the treatment of medial osteoarthritis.

摘要

目的

我们评估了牛津三期单髁膝关节置换术(UKA)治疗内侧骨关节炎患者的中期结果。

方法

27例患者(24例女性,3例男性;平均年龄57岁;范围47至73岁)因内侧膝关节骨关节炎接受牛津三期UKA手术。所有患者均为原发性骨关节炎,但有1例为自发性骨坏死。9个膝关节为阿尔贝克2级,18个膝关节为3级。所有股骨和胫骨组件均采用骨水泥固定,所有患者均使用活动胫骨聚乙烯衬垫。术前和术后评估采用膝关节协会临床评分系统。平均随访28个月(范围24至36个月)。

结果

与术前值相比,末次随访时以下各项有显著改善(p<0.05):膝关节屈曲(分别为106.4度和117.4度)、胫股角(内翻7度和外翻1度)、膝关节评分(47.5和78.9)以及膝关节功能评分(48.7和83.6)。仅2例患者需要输血。未发生包括感染、深静脉血栓形成、肺栓塞和神经血管损伤在内的重大并发症。2例患者分别在术后8个月和10个月因胫骨平台逐渐塌陷而接受翻修手术。膝关节协会临床评分在21例(77.8%)患者中为优或良,4例(14.8%)为中等,2例(7.4%)为差。功能结果的相应数字分别为23例(85.2%)、2例(7.4%)和2例(7.4%)。

结论

我们的结果表明,牛津三期UKA治疗内侧骨关节炎有效且相当成功。

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