中国修复重建外科杂志

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髌股关节炎对人工单髁关节置换术疗效影响的研究进展

王宇 1 , 岳家吉 2 , 杨春喜 1 ,

1. 上海交通大学医学院附属仁济医院骨关节外科（上海  200127） ;
2. 中国医科大学附属第一医院关节与运动医学科（沈阳 110000）

收稿日期: 2018-06-03;  修回日期:2019-01-06; 

基金项目: 上海市科学技术委员会引导项目（16411971700）

通讯作者: 杨春喜, Email: chunxi_yang@163.com

Research progress about influence of patellofemoral osteoarthritis on effectiveness of unicompartmental knee arthroplasty

WANG Yu 1 , YUE Jiaji 2 , YANG Chunxi 1 ,

1. Department of Orthopaedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P.R.China ;
2. Department of Sports Medicine and Joint Surgery, the First Hospital of China Medical University, Shenyang Liaoning, 110000, P.R.China

Corresponding Author: YANG Chunxi, Email: chunxi_yang@163.com

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目的 总结髌股关节炎对人工单髁关节置换术（unicompartmental knee arthroplasty，UKA）疗效影响的研究进展。 方法 广泛查阅近年来国内外相关文献，对支持和反对将髌股关节炎作为 UKA 禁忌证的论据进行分析总结。 结果 传统观点认为髌股关节炎为 UKA 的禁忌证，但目前多数研究显示髌股关节软骨损伤甚至全层缺损对 UKA 疗效无显著影响，术前存在膝前痛和髌股关节内侧退变与 UKA 预后无相关性。但髌骨外侧半脱位者 UKA 术后易出现髌前痛，髌股关节外侧退变可能是影响 UKA 预后的危险因素。 结论 髌股关节炎不是 UKA 的绝对禁忌证，而髌股关节外侧退变对手术疗效影响尚不明确，需进一步研究。

Objective To summarize the current research progress about influence of patellofemoral osteoarthritis on clinical outcome of unicompartmental knee arthroplasty (UKA). Methods The recent related literature was extensively reviewed and summarized, including pros and cons to regard the patellofemoral osteoarthritis as the contraindication. Results Previous studies regarded patellofemoral osteoarthritis as the contraindication of UKA. Most of current researches show that the damage to the articular cartilage of the patellofemoral joint to the extent of full-thickness cartilage loss has no influence on outcome of UKA. There is no correlation between preoperative anterior knee pain or medial patellofemoral joint degeneration and the clinical outcome. However, lateral subluxation of the patella has an adverse impact on postoperative curative effect. Degeneration of the lateral patellofemoral joint may be a risk factor of the outcome. Conclusion Patellofemoral osteoarthritis should not be the absolute contraindication of UKA. The effect of degeneration of the lateral patellofemoral joint is not clear at present, and still needs further studies in the future.

关键词: 人工单髁关节置换术; 髌股关节炎; 临床预后

Key words: Unicompartmental knee arthroplasty; patellofemoral osteoarthritis; clinical outcome

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