Koshino Tomihisa, Sato Koji, Umemoto Yusuke, Akamatsu Yasushi, Kumagai Ken, Saito Tomoyuki
Orthopaedic Surgery, Yokohama City University School of Medicine, Yokohama, Japan,
Int Orthop. 2015 Jun;39(6):1085-91. doi: 10.1007/s00264-014-2564-y. Epub 2014 Oct 24.
Unicompartmental knee prostheses with screw fixation into the proximal tibia were employed and postoperative clinical results for osteoarthritis of the knee, especially regarding relief of pain, range of motion and satisfactory limb alignment are reported and discussed.
A total of 140 knees (131 medial and 9 lateral) of 85 patients (21 men and 64 women) were followed up for two to 17 years with an average of 7.0 ± 3.0 years.
In spite of loss to follow-up in three knees of two patients and revision to total knee arthroplasty in one knee of one patient, in the remaining 136 knees (82 patients) the mean knee score of the Knee Society Clinical Rating System was 41.0 ± 14.7 pre-operatively, which improved to 93.1 ± 5.7 at follow-up, while the mean functional score similarly improved from 36.9 ± 8.1 to 88.5 ± 6.3 (p < 0.001 respectively). One knee developed a fracture in the medial proximal part of the tibia, but no knee developed loosening of the prosthesis or infection. The mean pre-operative knee flexion was 122.6 ± 15.9°, which improved to 132.9 ± 13.4° (p < 0.001) at follow-up. The limb alignment showed 4.8 ± 4.5° anatomical varus angulation pre-operatively, which was corrected to 5.8 ± 3.3° valgus at follow-up in the medial unicompartmental replacement group (127 knees), and 19 ± 6.1° valgus pre-operatively, which was corrected to 6.7 ± 3.0° valgus at follow-up in the lateral unicompartmental replacement group (nine knees).
The clinical results of arthroplasty with screw fixation were concluded to be promising.
采用螺钉固定于胫骨近端的单髁膝关节假体,报告并讨论其治疗膝关节骨关节炎的术后临床结果,尤其关注疼痛缓解、活动范围及满意的下肢对线情况。
对85例患者(21例男性和64例女性)的140个膝关节(131个内侧膝关节和9个外侧膝关节)进行了2至17年的随访,平均随访时间为7.0±3.0年。
尽管有2例患者的3个膝关节失访,1例患者的1个膝关节翻修为全膝关节置换术,但在其余136个膝关节(82例患者)中,膝关节协会临床评分系统的平均膝关节评分术前为41.0±14.7,随访时提高到93.1±5.7,而平均功能评分同样从36.9±8.1提高到88.5±6.3(p均<0.001)。1个膝关节发生胫骨近端内侧骨折,但无膝关节出现假体松动或感染。术前膝关节平均屈曲度为122.6±15.9°,随访时提高到132.9±13.4°(p<0.001)。在内侧单髁置换组(127个膝关节)中,下肢对线术前显示4.8±4.5°解剖内翻角,随访时矫正为5.8±3.3°外翻;在外侧单髁置换组(9个膝关节)中,术前为19±6.1°外翻,随访时矫正为6.7±3.0°外翻。
螺钉固定关节成形术的临床结果很有前景。