Tian Shaoqi, Wang Bin, Liu Lun, Ha Chengzhi, Yuanhe Wang, Liu Jiangjun, Li Qicai, Yang Xu, Sun Kang
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Dec;29(12):1457-61.
To explore the short- and mid-term effectivenesses of combined unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament (ACL) reconstruction for osteoarthritis (OA) and ACL injury.
Between January 2006 and January 2014, 32 patients with knee OA and ACL injury were treated by combined UKA and ACL reconstruction. There were 12 males and 20 females, aged 41-63 years (mean, 50 years); 17 left knees and 15 right knees were involved. The causes of ACL injury were sports injury (25 cases) and traffic accident injury (7 cases), including 27 cases of old injury and 5 cases of acute injury. Pain of the medial compartment of the knee and unstable knee joint were the main clinical symptoms. Preoperative X-ray films showed (3.1 ± 0.6)° of varus deformity.
All incisions healed by first intention, without complication. The patients were followed up 16-112 months (mean, 55 months). Mobile bearing dislocation occurred in 2 cases after operation, and was cured after replacing much thicker mobile bearings. X-ray films showed (4.0 ± 0.7)° of valgus at last follow-up. There was no loosening of the prosthesis. Physiological radiolucent line (< 1 mm) was observed around the tibial component in 10 patients. The Oxford Knee Score (OKS), Knee Society Score (KSS) clinical score, KSS functional score, and Tegner activity score at last follow-up were improved significantly (P < 0.05). The range of motion (ROM) of the operated knee was (123.5 ± 2.8)°, and the posterior slope of the tibial component was (3.9 ± 1.2)° at last follow-up; a significant correlation was found between ROM and posterior slope according to the Pearson's correlation (r = 0.392, P = 0.031).
Combined UKA and ACL reconstruction has good short- and mid-term effectivenesses for OA and ACL injury.
探讨单髁膝关节置换术(UKA)联合前交叉韧带(ACL)重建治疗骨关节炎(OA)合并ACL损伤的短期和中期疗效。
2006年1月至2014年1月,对32例膝关节OA合并ACL损伤患者行UKA联合ACL重建术。其中男12例,女20例,年龄41 - 63岁(平均50岁);累及左膝17例,右膝15例。ACL损伤原因:运动损伤25例,交通事故伤7例,其中陈旧伤27例,急性伤5例。膝关节内侧间室疼痛及膝关节不稳为主要临床症状。术前X线片显示内翻畸形(3.1±0.6)°。
所有切口均一期愈合,无并发症发生。患者随访16 - 112个月(平均55个月)。术后2例发生活动平台脱位,更换更厚的活动平台后治愈。末次随访时X线片显示外翻(4.0±0.7)°。假体无松动。10例患者胫骨假体周围可见生理性透亮线(<1 mm)。末次随访时牛津膝关节评分(OKS)、膝关节协会评分(KSS)临床评分、KSS功能评分及Tegner活动评分均显著改善(P<0.05)。末次随访时患膝关节活动度(ROM)为(123.5±2.8)°,胫骨假体后倾角为(3.9±1.2)°;Pearson相关性分析显示ROM与后倾角呈显著相关(r = 0.392,P = 0.031)。
UKA联合ACL重建治疗OA合并ACL损伤具有良好的短期和中期疗效。