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[成功的内侧单髁膝关节置换术——最重要的手术技巧有哪些?]

[Successful medial unicompartmental knee arthroplasty-What are the most important surgical tricks?].

作者信息

Waldstein Wenzel, Aldinger Peter R, Merle Christian

机构信息

Orthopädische Klinik Paulinenhilfe, Diakonie-Klinikum Stuttgart, Rosenbergstr. 38, 70176, Stuttgart, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Apr;53(4):265-274. doi: 10.1007/s00132-024-04479-6. Epub 2024 Mar 5.

Abstract

BACKGROUND

Unicompartmental knee arthroplasty (UKA) is an established surgical treatment option for end-stage anteromedial osteoarthritis with excellent functional outcomes and implant survival. Routine preoperative varus and valgus stress views are crucial for the selection of patients for unicompartmental or total knee arthroplasty.

THERAPY

UKA is a soft-tissue based operation that aims to reconstruct the individual joint line and pre-arthritic alignment by restoring the physiological tension of the medial collateral and the cruciate ligaments.

RESULTS

Current data for medial UKA show excellent results for both mobile and fixed bearing implant designs with the correct indication and surgical technique. Cementless fixation offers potential advantages over cemented implants. Registry data demonstrate that institutions and surgeons specializing in partial knee replacement (> 30 cases/year per surgeon, > 100/year per institution) with a high percentage of UKA relative to the total number of knee implants (> 20%) have significantly lower revision rates.

摘要

背景

单髁膝关节置换术(UKA)是终末期前内侧骨关节炎的一种成熟手术治疗选择,具有出色的功能结果和植入物生存率。术前常规内外翻应力位片对于选择单髁或全膝关节置换术患者至关重要。

治疗

UKA是一种基于软组织的手术,旨在通过恢复内侧副韧带和交叉韧带的生理张力来重建个体关节线和关节炎前对线。

结果

目前内侧UKA的数据显示,对于活动和固定承重植入物设计,在有正确适应证和手术技术的情况下,结果良好。非骨水泥固定相对于骨水泥植入物具有潜在优势。登记数据表明,专门从事部分膝关节置换术(每位外科医生每年>30例,每个机构每年>100例)且UKA占膝关节植入物总数比例较高(>20%)的机构和外科医生,其翻修率显著较低。

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