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单髁膝关节置换术治疗创伤后膝关节炎的短期和中期疗效

[Short- and mid-term effectiveness of unicompartmental knee arthroplasty for post-traumatic arthritis of knee].

作者信息

Xue Huaming, Ma Tong, Wen Tao, Yang Tao, Xue Long, Lei Xuefeng, Ji Jiazhong, Zhang Wenzheng, Tu Yihui

机构信息

Department of Joint Surgery, Yangpu Hospital Affiliated to Tongji University, Shanghai, 200090, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jun 15;37(6):647-652. doi: 10.7507/1002-1892.202303051.

Abstract

OBJECTIVE

To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee.

METHODS

The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m (range, 19.8-35.6 kg/m ). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb.

RESULTS

The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation <0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( <0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision.

CONCLUSION

For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.

摘要

目的

探讨单髁膝关节置换术(UKA)治疗膝关节创伤后关节炎(PTA)的短期和中期疗效。

方法

回顾性分析2014年3月至2021年9月间30例单侧膝关节PTA患者的临床资料。其中男性14例,女性16例,平均年龄64.5岁(范围33 - 81岁)。平均体重指数为26.7kg/m²(范围19.8 - 35.6kg/m²)。导致PTA的损伤类型包括关节内骨折16例,关节外骨折8例,软组织损伤6例。初始损伤采用保守治疗12例,手术治疗18例。内侧间室骨关节炎10例,外侧间室骨关节炎20例。根据Kellgren-Lawrence分级,Ⅲ级19例,Ⅳ级11例。记录手术时间、住院时间、并发症及主观满意度。采用牛津膝关节功能评分(OKS)、特种外科医院(HSS)评分及膝关节活动度(ROM)评估膝关节功能。拍摄负重X线片测量股骨-胫骨角(FTA)并评估下肢对线矫正情况。

结果

手术时间为50至95分钟(平均63.7分钟),住院时间为3至8天(平均6.9天)。2例发生浅表感染,其余切口一期愈合。未发生深静脉血栓形成或神经血管损伤。所有患者均获随访17 - 109个月(中位时间70个月)。末次随访时,30例患者的OKS评分、HSS评分及ROM较术前均显著改善(P<0.05)。下肢对线显著矫正,内翻和外翻膝关节术前术后FTA差异有统计学意义(P<0.05)。患者满意度为86.7%(26/30)。随访期间2例对侧骨关节炎进展。未发生假体脱位、松动或下沉,均无需进一步翻修。

结论

对于膝关节PTA患者,UKA可获得确切的短期和中期疗效,患者满意度高。

相似文献

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Unicompartmental Knee Arthroplasty Is Associated With a Lower Rate of Periprosthetic Joint Infection Compared to Total Knee Arthroplasty.
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