Kozinn S C, Scott R D
Institute for Bone and Joint Disorders, Phoenix, Arizona.
Rheum Dis Clin North Am. 1988 Dec;14(3):545-64.
The number of patients with unicompartmental osteoarthritis is increasing with the average age of our population. Good surgical techniques are available to improve pain and increase motion in the knee with degenerative disease. It is important to make early accurate diagnoses in arthritic patients so that the least surgically ablative procedure can be performed that will maximally benefit each patient. Total knee replacement is an extremely effective operation for relieving pain, but its major drawback is the large amount of bone stock that must be sacrificed during the procedure. Unicondylar knee replacement has proven itself to be an excellent alternative to total knee replacement in more limited arthritic disease. High tibial osteotomy still plays a major role as treatment for unicompartmental arthritis in younger and more active patients. McKeever interpositional hemiarthroplasty is an alternative in young patients when osteotomy is contraindicated. Arthroscopy is playing an increasing role in both diagnosis and treatment of unicompartmental osteoarthritis. The decision to perform unicompartmental arthroplasty, osteotomy, or total knee replacement is made on an individual basis. The extent of cartilage degeneration in the knee as well as the age, weight, and activity demands of the patient help to guide that decision.
随着我国人口平均年龄的增长，单间室骨关节炎患者的数量正在增加。目前已有良好的外科技术可用于改善膝关节退行性疾病患者的疼痛并增加膝关节活动度。对关节炎患者进行早期准确诊断非常重要，以便能够实施创伤最小的手术，从而使每位患者获得最大益处。全膝关节置换术是缓解疼痛的极其有效的手术，但其主要缺点是手术过程中必须牺牲大量的骨量。在局限性关节炎疾病中，单髁膝关节置换已证明是全膝关节置换的极佳替代方案。高位胫骨截骨术在治疗年轻且活动较多的患者的单间室关节炎方面仍发挥着重要作用。当截骨术禁忌时，麦克尤恩（McKeever）间置式半关节成形术是年轻患者的一种选择。关节镜检查在单间室骨关节炎的诊断和治疗中发挥着越来越重要的作用。实施单髁关节置换术、截骨术还是全膝关节置换术，需根据个体情况做出决定。膝关节软骨退变的程度以及患者的年龄、体重和活动需求有助于指导这一决策。
