单髁置换术治疗前交叉韧带缺失的高龄膝关节内侧骨关节炎的疗效分析
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作者Author单位AddressE-Mail
梁海松 LIANG Hai-song 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China  
盛东 SHENG Dong 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China 297252606@qq.com 
惠小苏 HUI Xiao-su 重庆市中医院, 重庆 400000 Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400000, China  
白新文 BAI Xin-wen 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China  
邓煜 DENG Yu 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China  
舒从科 SHU Cong-ke 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China  
向发松 XIANG Fa-song 重庆市中医骨科医院, 重庆 400010 Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China  
期刊信息:《中国骨伤》2025年,第38卷,第4期,第336-342页
DOI:10.12200/j.issn.1003-0034.20240224
基金项目:重庆市技术创新与应用发展专项面上项目(编号:cstc2019jscx-msxmX0229);重庆市科委联合医学科研项目(编号:2020FYYX130);重庆市卫生健康委医学科研项目(编号:2022WSJK140)
中文摘要:

目的: 探讨单髁置换术(unicompartmental knee arthroplasty,UKA)治疗前交叉韧带缺失(anterior cruciateligament deficinency,ACLD)的高龄膝关节内侧骨关节炎的中短期临床疗效。

方法: 回顾分析2018年1月至2022年12月进行UKA的75岁以上原发性膝关节内侧骨关节炎合并ACLD的31例患者的临床资料,男12例,女19例;年龄75~91(79.56±4.54)岁;左膝13例,右膝16例,双膝2例。术前和末次随访时采用视觉模拟量表(visual analoguescale,VAS)评分评价术侧膝关节疼痛情况,采用美国特种外科医院(Hospital for Special Surgery,HSS)评分评价术侧膝关节功能情况,采用活动度评价术侧膝关节屈伸活动情况,采用髋-膝-踝角评价手术前后术侧膝关节内翻情况,测量并记录术后胫骨假体后倾角,并观察是否存在感染及假体磨损、松动、脱位等并发症。

结果: 31例均获得随访,时间12~63(28.34±10.56)个月。术后胫骨假体后倾角为2.5~6.8(4.83±1.31)°。末次随访患者VAS (3.24±0.53)分、HSS (85.19±4.45)分、膝关节活动度(118.83±5.38)°、髋-膝-踝角(176.83±5.16)°,与术前(6.59±0.69)分、(64.38±5.94)分、(98.85±4.08)°、(169.57±6.28)°比较均有明显改善,差异有统计学意义(P<0.05)。所有患者未见感染及假体松动、脱位等并发症。

结论: 单髁置换术治疗合并ACLD的高龄膝关节内侧骨关节炎中短期临床疗效良好,但长期临床疗效尚需进一步的随访研究。
【关键词】单髁置换  前交叉韧带缺失  高龄  膝关节内侧骨关节炎
 
Clinical study on the efficacy of unicompartmental knee arthroplasty in elderly patients with medial osteoarthritis and anterior cruciate ligament deficiency
ABSTRACT  

Objective To investigate the short and med term clinical efficacy of unicompartmental knee arthroplasty(UKA)for the treatment of medial knee osteoarthritis (OA) in elderly patients with anterior cruciate ligament deficiency(ACLD).

Methods A retrospective analysis was conducted on 31 patients aged over 75 years old with primary medial knee OA and ACLD who underwent UKA between January 2018 and December 2022. The cohort included 12 males and 19 females,aged from 75 to 91 years with an average age of (79.56±4.54) years,with 13 left knee,16 right knee,and 2 bilateral knees. Clinical outcomes were assessed preoperatively and at final follow up using the visual analogue scale (VAS),Hospital for Special Surgery (HSS) score,range of motion (ROM),hip knee ankle angle (HKA),and tibial component posterior slope angle (TCPSA). Complications such as infection,prosthesis wear,prosthesis loosening,and dislocation were also recorded.

Results All 31 patients were followed up from 12 to 63 months with an average of (28.34±10.56) months. The average postoperative TCPSA was (4.83±1.31)° ranged from 2.5° to 6.8°. At the final follow up,there was significant improvement in VAS (3.24±0.53) vs. (6.59±0.69),HSS score (85.19±4.45) vs. (64.38±5.94),ROM (118.83±5.38)° vs. (98.85±4.08)°,and HKA (176.83±5.16)° vs. (169.57±6.28)° compared to preoperative values (P<0.05). No cases of infection,prosthesis loosening,or dislocation were reported.

Conclusion UKA provides favorable short and mid term outcomes for elderly patients with medial knee OA and ACLD. However,long term clinical efficacy needs further investigation through extended follow up.
KEY WORDS  Unicompartmental knee arthroplasty  Anterior cruciate ligament deficinency  Elderly patients  Medial osteoarthritis of the knee
 
引用本文,请按以下格式著录参考文献:
中文格式:梁海松,盛东,惠小苏,白新文,邓煜,舒从科,向发松.单髁置换术治疗前交叉韧带缺失的高龄膝关节内侧骨关节炎的疗效分析[J].中国骨伤,2025,38(4):336~342
英文格式:LIANG Hai-song,SHENG Dong,HUI Xiao-su,BAI Xin-wen,DENG Yu,SHU Cong-ke,XIANG Fa-song.Clinical study on the efficacy of unicompartmental knee arthroplasty in elderly patients with medial osteoarthritis and anterior cruciate ligament deficiency[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(4):336~342
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