Jones W T, Bryan R S, Peterson L F, Ilstrup D M
J Bone Joint Surg Am. 1981 Jul;63(6):946-54.
Unicompartmental knee arthroplasty was performed in 207 knees of 179 patients using either a polycentric (188) or a geometric (nineteen) hemicomponent. After an average follow-up of 2.6 years, the results in 184 (89 per cent) of the knees were satisfactory. Pain and the need for ambulatory aids were reduced, and the distance the patients could walk was increased. Twenty-three (11 per cent) of the 207 procedures were rated as failures. The major cause of failure was loosening of the components (tibial in twelve and femoral in one); there also were unexplained pain in five knees, problems with the opposite unreplaced compartment in three, technical error in one, and pain in the patellofemoral joint in one. Nine of 155 intraoperative specimens for bacterial culture obtained during unicompartmental arthroplasty were positive, and two specimens that were positive on culture were obtained during revision of twenty failed unicompartmental arthroplasties. No gross or histological evidence of infection was demonstrated at operation. Based on this study, we concluded that this procedure can provide satisfactory relief of pain, adequate knee motion, and increased levels of independence and activity for patients with unicompartmental disease who are not suitable candidates for proximal tibial osteotomy or total knee replacement.
对179例患者的207个膝关节进行了单髁膝关节置换术，使用多中心（188个）或几何型（19个）半关节组件。平均随访2.6年后，184个（89%）膝关节的结果令人满意。疼痛减轻，对助行器的需求减少，患者行走距离增加。207例手术中有23例（11%）被评为失败。失败的主要原因是组件松动（胫骨组件12例，股骨组件1例）；还有5个膝关节出现不明原因疼痛，3个对侧未置换关节出现问题，1例技术失误，1例髌股关节疼痛。在单髁关节置换术中获取的155份术中细菌培养标本中有9份呈阳性，在20例失败的单髁关节置换术翻修术中获取的2份培养阳性标本。手术中未发现明显或组织学上的感染证据。基于这项研究，我们得出结论，对于不适合近端胫骨截骨术或全膝关节置换术的单髁疾病患者，该手术可以提供令人满意的疼痛缓解、足够的膝关节活动度以及更高的独立性和活动水平。
