目的:探讨改良型胫骨髓外定位技术应用于膝单髁关节置换术(unicompartmental knee arthroplasty，U-KA)治疗单间室骨性关节炎患者的临床疗效。方法:回顾性分析2018年5月至2022年2月，采用改良型胫骨髓外定位技术UKA治疗的75例膝关节单间室骨性关节炎患者，男33例，女42例;年龄52～73(64。0±6。0)岁;病程0。5～11。0(3。2±2。7)年;左侧31例，右侧37例，双侧手术7例。采用膝关节正侧位X线片评价假体位置，观察其术后并发症情况。比较术前和术后1年疼痛视觉模拟评分(visual analog scale，VAS)、美国特种外科医院膝关节功能(Hospital for Special Surgery，HSS)评分。术后1年采用遗忘关节评分(forgotten joint score，FJS)评价患者的遗忘程度。结果:75例患者获得随访，时间12～15(13。0±1。5)个月。2例术后发生并发症，其中1例为切口浅表感染，换药后愈合;1例术后1个月出现关节腔内出血，予关节镜清理手术后好转。VAS由术前的(6。4±0。9)分降低至术后1年的(2。3±0。3)分(P＜0。01)，HSS评分由术前的(65。2±7。5)分提高至术后1年的(92。8±5。3)分(P＜0。01)。FJS术后1年为(70。5±2。3)分，表示患者对手术后膝关节的感觉接近本体感觉。结论:UKA对于单间室骨性关节炎具有确切的临床疗效，可减轻术后疼痛，提高膝关节功能，是治疗单间室骨关节炎的主要手术方式。运用改良型胫骨髓外定位技术可以在术中更加方便、准确地定位截骨方向及假体位置，并取得良好的临床疗效。
Application of modified tibial extramedullary localization technique in Link-Sled prosthesis for unicompartmental knee arthroplasty and its clinical efficacy
Objective To explore clinical effect of modified tibial extramedullary localization technique applied to uni-compartmental knee arthroplasty(UKA)in patients with single compartment osteoarthritis.Methods From May 2018 to Febru-ary 2022,75 patients with single-compartment osteoarthritis of knee joint(33 males and 42 females)were treated with modi-fied tibial extramedullary localization technique UKA,aged from 52 to 73 years old with an average of(64.0±6.0)years old;the course of disease ranged from 0.5 to 11.0 years with an average of(3.2±2.7)years;31 patients on the left side,37 patients on the right side and 7 patients on both sides.The position of prosthesis was evaluated by AP and lateral X-ray of knee joint and postoperative complications were observed.Visual analog scale(VAS)and Hospital for Special Surgery(HSS)of knee score were compared before and 1 year after operation.Forgotten joint score(FJS)was used to evaluate degree of amnesia at 1 year after operation.Results Seventy-five patients were followed up for 12 to 15 months with an average of(13.0±1.5)months.Postoperative complications were occurred in 2 patients,of which 1 patient was superficial incision infection,which healed after dressing change.One patient was developed intraarticular bleeding at 1 month after operation,which was improved after arthroscopic cleaning.VAS was decreased from(6.4±0.9)before operation to(2.3±0.3)at 1 year after operation(P＜0.01),and HSS was increased from(65.2±7.5)before operation to(92.8±5.3)at 1 year after operation(P＜0.01).FJS score at 1 year after operation was(70.5±2.3),indicating that the sensation of knee joint after operation was close to proprioception.Conclu-sion UKA has definite clinical effect on single-compartment osteoarthritis,which could reduce postoperative pain,improve knee joint function,and is the main surgical treatment for single-compartment osteoarthritis.The modified tibial extramedullary localization technique could be used to locate osteotomy direction and prosthesis position more conveniently and accurately during operation,and obtain good clinical effect.
万方数据
维普
