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外侧单髁膝关节置换术:综述。

Lateral unicompartmental knee arthroplasty: a review.

机构信息

Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.

出版信息

Arch Orthop Trauma Surg. 2010 Dec;130(12):1539-48. doi: 10.1007/s00402-010-1137-9. Epub 2010 Jun 18.

Abstract

Lateral unicondylar knee arthroplasty (UKA) has been utilized as a treatment for isolated lateral tibiofemoral osteoarthritis (OA) since the first description of UKA in the 1970s. To date, there remains some controversy on UKA procedures. As indications for lateral UKA are usually rare, surgeon experience seems to be the key factor for a successful intervention. Better understanding of biomechanics of the knee joint, recent developments in prosthesis design, surgical techniques and indications may add to improved outcomes of lateral UKA. Alternatives that are applied to treat lateral tibiofemoral OA include arthroscopic interventions, osteotomies and total knee arthroplasty (TKA). In comparison with TKA, potential advantages of UKA include a minimally or less invasive approach, less bone resection, preservation of the cruciate ligaments, preservation of the medial tibiofemoral and the patellofemoral compartments, shorter rehabilitation, and physiological knee kinematics. This review aims to summarize the current concepts of implant designs as well as indications and contraindications for lateral UKA. The literature will be presented and discussed as well as results and realistic expectations on both the surgeon's and the patient's side. Alternative treatments and future concepts for lateral UKA will be presented.

摘要

外侧单髁膝关节置换术(UKA)自 20 世纪 70 年代首次描述以来,已被用于治疗孤立性外侧胫股关节炎(OA)。迄今为止,关于 UKA 手术仍存在一些争议。由于外侧 UKA 的适应证通常很少见,因此外科医生的经验似乎是成功干预的关键因素。更好地了解膝关节的生物力学、假体设计、手术技术和适应证的最新进展可能会提高外侧 UKA 的效果。用于治疗外侧胫股 OA 的替代方法包括关节镜干预、截骨术和全膝关节置换术(TKA)。与 TKA 相比,UKA 的潜在优势包括微创或更少的侵入性方法、更少的骨切除、保留交叉韧带、保留内侧胫股和髌股关节间室、更短的康复时间以及生理性膝关节运动学。本文旨在总结目前关于植入物设计的概念,以及外侧 UKA 的适应证和禁忌证。将介绍并讨论文献以及外科医生和患者双方的结果和现实期望。还将介绍外侧 UKA 的替代治疗方法和未来概念。

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