中国修复重建外科杂志

中国修复重建外科杂志

第三代 Oxford 单髁假体安放位置对人工单髁关节置换术近期疗效的影响

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目的 探究第 3 代 Oxford 单髁假体安放位置对人工单髁关节置换术(unicompartmental knee arthroplasy,UKA)近期疗效的影响。 方法 将 2015 年 9 月—11 月收治并符合标准的 26 例(26 膝)膝关节前内侧骨关节炎患者纳入研究,其中 15 例采用单柱型假体(单柱组)、11 例采用双柱型假体(双柱组)行 UKA。两组患者性别、年龄、体质量指数、骨关节炎 Kellgren-Lawrence 分级和术前美国特种医院(HSS)评分等一般资料比较,差异均无统计学意义(P>0.05)。随访时功能评价采用 HSS 评分、美国西部 Ontario 与 McMaster 大学骨关节炎评分(WOMAC)、牛津膝关节评分(OKS)和美国膝关节学会评分(KSS);组件安放位置评价采用 Oxford 单髁假体影像学评分,同时记录衬垫脱位等并发症发生情况。 结果 单柱组随访时间为 24~26 个月,平均 26.2 个月;双柱组随访时间为 24~26 个月,平均 25.2 个月。术后仅双柱组 2 例出现衬垫脱位。末次随访时,两组膝关节功能 HSS 评分、WOMAC 评分、OKS 评分、KSS 评分比较,差异均无统计学意义(P>0.05)。X 线片测量示两组股骨组件、胫骨组件以及总体组件影像学评分比较,差异均无统计学意义(P>0.05)。相关分析示,两组假体位置和术后关节功能间无相关性(P>0.05)。 结论 在一定安全范围内,第 3 代 Oxford 单髁假体安放位置对 UKA 近期疗效无明显影响。

Objective To investigate effect of the accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty (UKA). Methods The clinical data of 26 patients (26 knees) who were treated with UKA between September 2015 and November 2015 were retrospectively analyzed. The single-peg Oxford prosthesis was implanted in 15 patients (single-peg group), and twin-peg Oxford prosthesis was implanted in 11 patients (twin-peg group). There was no significant difference in gender, age, body mass index, Kellgren-Lawrence grading, and preoperative Hospital for Special Surgery (HSS) scores between 2 groups (P>0.05). HSS, knee society score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Oxford knee score (OKS) were used to evaluate the knee function. Radiographic criteria for Oxford UKA was used to evaluate the prosthesis position. The reason and treatment of bearing dislocations were recorded. Results All patients were followed up with mean follow-up time of 26.2 months in single-peg group (range, 24-26 months) and 25.2 months in twin-peg group (range, 24-26 months). The bearing dislocation occurred in 2 cases of twin-peg group during follow-up. At last follow-up, there was no significant difference in HSS, WOMAC, OKS, and KSS scores between 2 groups (P>0.05). There was no significant difference in radiographic scores of femoral component, tibial component, and overall components between 2 groups (P>0.05). No significant correlation was found between radiographic scores and postoperative functional outcome in 2 groups (P>0.05). Conclusion Within a safe range, the accuracy of phase 3 Oxford prosthesis positioning has limited influence on the short-term functional outcome.

关键词: 人工单髁关节置换术; 第 3 代 Oxford 单髁假体; 影像学评分; 功能评分

Key words: Unicompartmental knee arthroplasty; phase 3 Oxford prosthesis; radiographic score; functional score

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