Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, 270 Boulevard Sainte Marguerite, BP 29, 13274, Marseille, France.
Int Orthop. 2014 Feb;38(2):449-55. doi: 10.1007/s00264-013-2222-9. Epub 2013 Dec 13.
Unicompartmental femoro-tibial osteoarthritis usually affects the medial compartment of the knee, but in 10%, the lateral compartment is primarily involved. Femoral osteotomy is attractive to avoid TKA in younger patients with low-grade unicompartmental osteoarthritis and a valgus deformity. However, only limited functional results can be expected for patients with Ahlback grade 2 or greater osteoarthritis. Moreover, because of previous skin incisions and hardware removal, TKA after femoral osteotomy remains a complex procedure with poor functional results. Unicompartmental knee arthroplasty for both the medial and the lateral compartments has been performed since the 1970s. In a patient with involvement of only one compartment, a medial or a lateral UKA can provide a quicker recovery and enhanced function when compared to TKA. In addition, it preserves bone stock and can be "easily" revised by a TKA. Technical improvements, combined with strict patient selection, have resulted in ten year survivorships greater than 90%. However, lateral UKA is technically more challenging than medial UKA due to the lower number of indications, as well as the functional anatomy of the lateral compartment. The goals of this article are to present up-to-date information concerning indications, patients' selection, surgical technique and results of lateral compartment UKA.
单间室膝骨关节炎通常影响膝关节的内侧间室，但在 10%的情况下，外侧间室是主要受累的部位。对于低级别单间室骨关节炎和外翻畸形的年轻患者，股骨截骨术具有避免全膝关节置换术的吸引力。然而，对于 Ahlback 分级 2 或更高的骨关节炎患者，只能预期有限的功能结果。此外，由于先前的皮肤切口和硬件移除，股骨截骨术后的全膝关节置换术仍然是一种复杂的手术，功能结果较差。自 20 世纪 70 年代以来，已经对内侧和外侧间室进行了单间室膝关节置换术。在仅涉及一个间室的患者中，与全膝关节置换术相比，内侧或外侧 UKA 可以更快地恢复和增强功能。此外，它保留了骨量，并且可以通过全膝关节置换术“轻松”修正。技术改进，结合严格的患者选择，导致十年生存率超过 90%。然而，由于适应证较少以及外侧间室的功能解剖结构，外侧 UKA 在技术上比内侧 UKA 更具挑战性。本文的目的是提供有关外侧间室 UKA 的适应证、患者选择、手术技术和结果的最新信息。
