固定平台与活动平台单髁置换治疗膝关节单间室骨性关节炎的病例对照研究
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作者Author单位AddressE-Mail
危立军 WEI Li-jun 舟山广安医院关节外科, 浙江 舟山 316102 Department of Joint Surgery, Guang'an Hospital of Zhoushan, Zhoushan 316102, Zhejiang, China 728813858@qq.com 
罗军 LUO Jun 舟山广安医院关节外科, 浙江 舟山 316102 Department of Joint Surgery, Guang'an Hospital of Zhoushan, Zhoushan 316102, Zhejiang, China  
易观俊 YI Guan-jun 舟山广安医院关节外科, 浙江 舟山 316102 Department of Joint Surgery, Guang'an Hospital of Zhoushan, Zhoushan 316102, Zhejiang, China  
柴重喜 CHAI Chong-xi 舟山广安医院关节外科, 浙江 舟山 316102 Department of Joint Surgery, Guang'an Hospital of Zhoushan, Zhoushan 316102, Zhejiang, China  
王鹏 WANG Peng 舟山广安医院关节外科, 浙江 舟山 316102 Department of Joint Surgery, Guang'an Hospital of Zhoushan, Zhoushan 316102, Zhejiang, China  
期刊信息:《中国骨伤》2020年,第33卷,第6期,第549-553页
DOI:10.12200/j.issn.1003-0034.2020.06.012
基金项目:舟山市医药卫生科技计划项目(编号:2018B20)
中文摘要:

目的:分析固定平台与活动平台单髁置换治疗膝关节单间室骨性关节炎的早期临床疗效。

方法:选取2013年1月至2014年12月关节骨病专科门诊就诊并收治住院手术的86例(92膝)膝关节单间室(内侧)骨性关节炎病例,分成两组:一组为固定平台(Link)组,共42例,其中男18例,女24例,选用固定平台假体行单髁置换手术;另一组为活动平台(Oxford)组,共44例,其中男20例,女24例,选用活动平台假体行单髁置换手术。由同一组医生完成手术,分别记录两组手术操作时间,术中失血量,术前与末次随访的膝关节活动度,进行膝关节美国特种外科医院(Hospital for Special Surgery,HSS)评分,膝关节协会评分(Knee Society Score,KSS)并完成临床随访。

结果:两组患者术后随访时间8~26(18.20±4.23)个月。临床随访过程发现在固定平台组术后1年出现1例假体周围骨折,活动平台组发现1例垫片脱位。所有患者未出现伤口愈合不良及假体周围感染、假体松动等并发症。固定平台组手术耗时(90.05±6.59)min,失血量(53.76±6.04)ml;活动平台组手术耗时(90.73±6.74)min,失血量(54.34±6.27)ml。固定平台组膝关节活动范围由术前(94.52±4.54)°提高至术后(104.64±4.42)°,活动平台组膝关节活动范围由术前(95.05±4.87)°提高至术后(105.07±4.33)°。固定平台组KSS评分由术前(48.69±5.68)分提高至术后(83.55±5.37)分,活动平台组KSS评分由术前(49.39±5.68)分提高至术后(84.11±6.14)分;固定平台组HSS评分由术前(45.45±3.62)分提高至术后(84.55±6.08)分,活动平台组HSS评分由术前(45.93±4.01)分提高至术后(85.16±6.30)分。两组间比较差异无统计学意义。

结论:使用固定平台和活动平台单髁假体在治疗膝关节单间室骨性关节炎的早期临床疗效比较差异无统计学意义,两者的中远期并发症和翻修率还有待进一步的多中心大样本临床研究。
【关键词】膝关节  关节成形术,置换,膝  骨关节炎,膝  病例对照研究
 
A case-control study of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee
ABSTRACT  

Objective: To compare and analyze the early clinical outcomes of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee.

Methods: From January 2013 to December 2014,86 cases(92 knees) of knee osteoarthritis with single compartment (medial) were randomly divided into two groups. One group consisted of 42 patients,including 18 males and 24 females,underwent unicompartmental knee arthroplasty with fixed platform prosthesis; the other group consisted of 44 patients,including 20 males and 24 females,underwent unicompartmental knee arthroplasty with mobile platform prosthesis. The surgery was performed by the same group of doctors. The operation time,blood loss,ROM,KSS and HSS scores of knee joint before and after surgery were recorded and the clinical follow-up was completed.

Results: The follow-up duration of the two groups ranged from 8 to 26 months,with an average of(18.20±4.23) months. During the follow-up period,the periprosthetic fracture was found in 1 patient in the fixed platform group 1 year after operation,and polyethylene liner dislocation was found in 1 patient in the mobile platform group. No complications such as poor wound healing,periprosthetic infection or sterile prothesis loosening were found in all cases. In the fixed platform group,the operation time was (90.05±6.59) minutes and the blood loss was (53.76±6.04) ml. In the mobile platform group,the operation time was(90.73±6.74) minutes and the blood loss was(54.34±6.27) ml. In the fixed platform group,the ROM of knee increased from preoperative(94.52±4.54) degree to postoperative(104.64±4.42) degree. In the mobile platform group,the ROM of knee increased from preoperative (95.05±4.87) degree to postoperative (105.07±4.33) degree. In the fixed platform group,the KSS score increased from preoperative 48.69±5.68 to postoperative 83.55±5.37. In the mobile platform group,the KSS score increased from preoperative 49.39±5.68 to postoperative 84.11±6.14. In the fixed platform group,the HSS score increased from preoperative 45.45±3.62 to postoperative 84.55±6.08. In the mobile platform group,the HSS score increased from preoperative 45.93±4.01 to postoperative 85.16±6.30. There was no significant difference between the two groups.

Conclusion: There is no significant difference in the early outcome of unicondylar prosthesis with fixed and mobile platforms in the treatment of single compartmental osteoarthritis of knee. The long-term complications and revision rates of the two prostheses need further multi-center and large-sample clinical study.
KEY WORDS  Knee joint  Arthroplasty,replacement,knee  Osteoarthritis,knee  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:危立军,罗军,易观俊,柴重喜,王鹏.固定平台与活动平台单髁置换治疗膝关节单间室骨性关节炎的病例对照研究[J].中国骨伤,2020,33(6):549~553
英文格式:WEI Li-jun,LUO Jun,YI Guan-jun,CHAI Chong-xi,WANG Peng.A case-control study of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(6):549~553
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