Heller Snir, Fenichel Itay, Salai Moshe, Luria Tal, Velkes Steven
Joint Surgery Unit, Department of Orthopedic Surgery, Rabin Medical Center, Petah Tikva, Israel.
Isr Med Assoc J. 2009 May;11(5):266-8.
Unicompartmental knee replacement has become a surgical alternative for treating isolated medial or lateral osteoarthritis of the knee or avascular necrosis of the femoral condyls.
To evaluate the short-term results of the Oxford Phase 3 unicompartmental knee replacement for unicompartmental knee arthrosis or avascular necrosis of the medial femoral condyle.
During the period 2003-2005 a total of 59 patients (59 knees) underwent medial Oxford Phase 3 unicompartmental knee replacement in our unit. The patients were interviewed and examined, and standing anteroposterior and lateral X-rays were taken. All patients completed the Western Ontario and McMaster Universities Index of Osteoarthritis and the Short Form 12 questionnaire, and the International Knee Society score was evaluated. The data were collected and statistical analysis was performed.
X-rays were performed and scores for the WOMAC and IKS were assessed for 42 patients (31 females, 11 males). At an average of 32 months after surgery the total WOMAC score was 30. The mean SF-12 physical score was 38 and the mean SF-12 mental score was 51. The mean IKS score was 166. Ninety-one percent of the patients had active flexion of 120 degrees or more. Of 59 knees 7 were converted to total knee arthroplasty--all of them within the first 2 years of starting the procedure and all of them in relatively young patients.
Despite the higher revision rate to TKR in this study, our findings confirm the short-term results reported in other studies of the Oxford medial unicompartmental knee and our early failure rate could be explained by a performance learning curve. This study confirms that this bone-preserving procedure should be considered in end-stage isolated unicompartmental osteoarthritis or avascular necrosis by surgeons who have the adequate training and experience.
单髁膝关节置换术已成为治疗膝关节孤立性内侧或外侧骨关节炎或股骨髁缺血性坏死的一种手术选择。
评估牛津三期单髁膝关节置换术治疗单髁膝关节病或股骨内侧髁缺血性坏死的短期效果。
2003年至2005年期间，我们单位共有59例患者（59膝）接受了牛津三期内侧单髁膝关节置换术。对患者进行了访谈和检查，并拍摄了站立位前后位和侧位X线片。所有患者均完成了西安大略和麦克马斯特大学骨关节炎指数以及简短健康调查问卷12项，并对国际膝关节协会评分进行了评估。收集数据并进行统计分析。
对42例患者（31例女性，11例男性）进行了X线检查，并评估了WOMAC和IKS评分。术后平均32个月时，WOMAC总分30分。SF-12身体评分平均为38分，SF-12心理评分平均为51分。IKS评分平均为166分。91%的患者主动屈曲度达120度或以上。59膝中有7膝转为全膝关节置换术——均在手术开始后的前2年内，且均为相对年轻的患者。
尽管本研究中转为全膝关节置换术的翻修率较高，但我们的研究结果证实了其他关于牛津内侧单髁膝关节研究报告的短期效果，我们的早期失败率可以用操作学习曲线来解释。本研究证实，对于有足够训练和经验的外科医生而言，在终末期孤立性单髁骨关节炎或缺血性坏死中应考虑这种保留骨质的手术。
