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伴有晚期骨关节炎或软骨下不全骨折的内侧半月板后根部撕裂是单髁膝关节置换术的良好适应证,至少随访2年。

Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up.

作者信息

Kawada Koki, Yokoyama Yusuke, Okazaki Yuki, Tamura Masanori, Ozaki Toshifumi, Furumatsu Takayuki

机构信息

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Department of Orthopaedic Surgery, Okayama Red Cross Hospital, 2-1-1 Aoe, Kitaku, Okayama, 700-8607, Japan.

出版信息

Arch Orthop Trauma Surg. 2024 Dec 18;145(1):64. doi: 10.1007/s00402-024-05671-1.

Abstract

INTRODUCTION

The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs.

MATERIALS AND METHODS

This study analyzed 68 patients. The presence or absence of MMPRTs was evaluated using preoperative magnetic resonance imaging. Patient characteristics, clinical scores before surgery and at the final evaluation, and imaging findings were compared between patients with and without MMPRTs. Multiple regression analysis was conducted on postoperative visual analog scale (VAS)-pain scores.

RESULTS

MMPRTs were present in 64.7% (44/68) of patients. Patients with MMPRTs were significantly younger (67.8 ± 8.2 vs. 75.0 ± 7.1 years, p < 0.001) and had a shorter duration from the development of symptoms to the time of surgery than those without (6.8 ± 8.4 vs. 36.1 ± 38.9 months, p < 0.001). Component placement or lower-limb alignment did not significantly differ between the groups. Preoperative clinical scores were not significantly different between the groups; however, patients with MMPRTs showed significantly better postoperative VAS-pain scores than those without (10.0 ± 9.0 vs. 28.2 ± 26.0 points, p = 0.026). Multiple regression analysis of postoperative VAS-pain scores revealed the significant effect of duration from the development of symptoms to the time of surgery (p = 0.038).

CONCLUSIONS

Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA.

摘要

引言

单髁膝关节置换术(UKA)在伴有和不伴有内侧半月板后根撕裂(MMPRT)情况下的疗效尚未进行比较。本研究比较了接受UKA手术的伴有和不伴有MMPRT患者的特征及临床疗效。

材料与方法

本研究分析了68例患者。术前通过磁共振成像评估是否存在MMPRT。比较了伴有和不伴有MMPRT患者的患者特征、术前及最终评估时的临床评分以及影像学表现。对术后视觉模拟评分(VAS)疼痛评分进行了多元回归分析。

结果

64.7%(44/68)的患者存在MMPRT。与无MMPRT的患者相比,伴有MMPRT的患者明显更年轻(67.8±8.2岁对75.0±7.1岁,p<0.001),且从症状出现到手术的时间更短(6.8±8.4个月对36.1±38.9个月,p<0.001)。两组之间的假体位置或下肢对线情况无显著差异。术前两组临床评分无显著差异;然而,伴有MMPRT的患者术后VAS疼痛评分明显优于无MMPRT的患者(10.0±9.0分对28.2±26.0分,p=0.026)。术后VAS疼痛评分的多元回归分析显示,从症状出现到手术的时间有显著影响(p=0.038)。

结论

与无MMPRT的患者相比,接受UKA手术且伴有MMPRT的患者更年轻,影像学上骨关节炎改变更少,且术后VAS疼痛评分明显更高。从症状出现到手术的时间对接受UKA手术的患者术后疼痛有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/211f/11655571/edabb45aeafb/402_2024_5671_Fig1_HTML.jpg

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