• 南方醫(yī)科大學(xué)第三附屬醫(yī)院骨科（廣州，510630）;

【摘 要】 目的 評價Oxford Ⅲ單髁系統(tǒng)治療膝關(guān)節(jié)內(nèi)側(cè)間室退變的中期臨床療效。 方法 2008年12月－2010年8月，收治26例（32膝）膝關(guān)節(jié)內(nèi)側(cè)間室退變患者，其中11例（14膝）獲2年以上隨訪。男7例（9膝），女4例（5膝）；年齡50～74歲，平均 62.4歲。左側(cè)6膝，右側(cè)8膝。均為退行性關(guān)節(jié)炎，病程5～23年，平均11.6年?；颊呔忻鞔_關(guān)節(jié)內(nèi)側(cè)間室負(fù)重疼痛和壓痛。內(nèi)側(cè)間室骨性關(guān)節(jié)炎根據(jù)Ahlback分期標(biāo)準(zhǔn)，Ⅱ期4膝，Ⅲ期10膝。膝關(guān)節(jié)均伴內(nèi)翻畸形；無主、被動屈伸活動受限。手術(shù)取髕內(nèi)側(cè)旁切口，采用Oxford Ⅲ單髁系統(tǒng)行膝關(guān)節(jié)內(nèi)側(cè)間室單髁置換手術(shù)。 結(jié)果 術(shù)后切口均Ⅰ期愈合。術(shù)后1～3個月5例出現(xiàn)切口下方局部鵝足疼痛癥狀，給予保守治療，術(shù)后6個月復(fù)查癥狀均消失。術(shù)后11例（14膝）均獲隨訪，隨訪時間24～30個月，平均27.5個月。隨訪期間無假體松動、移位，對側(cè)間室和髕股關(guān)節(jié)病變、感染等并發(fā)癥發(fā)生。末次隨訪時膝關(guān)節(jié)學(xué)會評分系統(tǒng)（KSS）評分、美國西部Ontario與McMaster大學(xué)骨關(guān)節(jié)炎指數(shù)評分（WOMAC）評分、膝關(guān)節(jié)活動度與術(shù)前比較，差異均有統(tǒng)計學(xué)意義（P  lt; 0.05）。末次隨訪時股脛角較術(shù)前改善（P  lt; 0.05），但仍為輕度內(nèi)翻；脛骨平臺內(nèi)翻角較術(shù)前有所增大，但無統(tǒng)計學(xué)意義（P  gt; 0.05）；脛骨內(nèi)髁后傾角明顯較術(shù)前減小，差異有統(tǒng)計學(xué)意義（P  lt; 0.05）。 結(jié)論 OxfordⅢ單髁系統(tǒng)治療膝關(guān)節(jié)內(nèi)側(cè)間室退變中期療效滿意，創(chuàng)傷小、恢復(fù)快；遠(yuǎn)期療效尚需進(jìn)一步觀察。

引用本文： 唐恒濤,趙亮,燕華,金大地,蘇訓(xùn)同. OxfordⅢ單髁系統(tǒng)治療膝關(guān)節(jié)內(nèi)側(cè)間室退變的中期療效. 中國修復(fù)重建外科雜志, 2012, 26(1): 17-20. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國修復(fù)重建外科雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. unicompartimental knee arhroplasty: a long term follow-up study. Orthop Traumatol Surg Res, 2009, 95(1): 12-21.
2. Arch Orthop Trauma Surg, 2009, 129(4): 463-468.
3. arthritis. J Bone Joint Surg (Am), 2002, 84-A(11): 1977-1981.
4. knee replacement: retrospective clinical and radiographic evaluation.
5. of 83 patients. Knee Surg Sports Traumatol Arthrosc, 2010, 18(6): 710-717.
6. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg (Br), 1992, 74(2): 228-232.
7. technique through a mini-incision. Clin Orthop Relat Res, 2007, (464): 32-36.
8. knee arthroplasty at a minimum of ten years follow-up. J Bone Joint Surg (Am), 2005, 87(5): 999-1006.
9. trail. J Bone Joint Surg (Br), 2009, 91(1): 52-57.
10. past, present, and future. Am J Orthop (Belle Mead NJ), 2009, 38(1): 17-23.
11. knee arthroplasty: survivorship and technical considerations.
12. at an average follow-up of 12.4 years. J Arthroplasty, 2006, 21(1): 13-17.
13. Lustig S, Paillot JL, Servien E, et al. Cemented all polyethylene tibial insert.
14. Naal FD, Neuerburg C, Salzmalm GM, et al. Association of body mass index and clinical outcome 2 years after unicompartmental knee arthroplasty.
15. Mont MA, Haas S, Mullick T, et al. Total knee arthroplasty for patellofemoral.
16. 蔣協(xié)遠(yuǎn), 王大偉. 骨科臨床療效評價標(biāo)準(zhǔn). 北京: 人民衛(wèi)生出版社, 2005: 275-277.
17. Bruni D, Iacono F, Russo A, et al. Minimally invasive unicompartmental.
18. Argenson JN, O’Connor JJ. Polyethylene wear in meniscal knee replacement.
19. Psychoyios V, Crawford RW, Murray DW, et al. Wear of congruent mensal bearings in unicompartmental knee replacement. J Bone Joint Surg (Br), 1998, 8(6): 976-982.
20. Mounasamy V, Sambandam S. Surgical management of young arthritic knee: a review. Eur J Orthop Surg Traumatol, 2008, 18(8): 555-564.
21. Scott RD, Cobb AG, McQueary FG, et al. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res, 1991, (271): 96-100.
22. Argenson JN, Parratte S, Flecher X, et al. Unicompartmental knee arthroplasty:.
23. Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental.
24. Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospective randomized controlled.
25. 張催, 陳游, 張春雷, 等. 單髁置換術(shù)與全膝關(guān)節(jié)置換術(shù)治療膝單間室骨性關(guān)節(jié)炎近中期療效的對比研究. 中華關(guān)節(jié)外科雜志(電子版), 2010, 4(2): 26-29.
26. Jamali AA, Scott RD, Rubash HE, et al. Unicompartmental knee arthroplasty:.
27. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern uni-compartmental knee arthroplasty with cenmet: a three to ten year follow-up study. J Bone Joint Surg (Am), 2002, 84-A(2): 2235-2239.
28. Pennington DW, Swienckowski JJ, Lutes WB, et al. Lateral unicompartmental.
29. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop, 2010, 34(8): 1137-1143.
30. 高遠(yuǎn)鵬, 紀(jì)斌平, 賈俊青, 等. 單髁置換治療膝關(guān)節(jié)骨性關(guān)節(jié)炎單間室病變. 中國現(xiàn)代醫(yī)生, 2009, 47(16): 48-49.
31. 胡懿郃, 王賢, 廖前德, 等. 單髁膝關(guān)節(jié)置換治療膝關(guān)節(jié)單間室病變. 中國矯形外科雜志, 2008, 16(3): 161-163.
  1. 1. unicompartimental knee arhroplasty: a long term follow-up study. Orthop Traumatol Surg Res, 2009, 95(1): 12-21.
  2. 2. Arch Orthop Trauma Surg, 2009, 129(4): 463-468.
  3. 3. arthritis. J Bone Joint Surg (Am), 2002, 84-A(11): 1977-1981.
  4. 4. knee replacement: retrospective clinical and radiographic evaluation.
  5. 5. of 83 patients. Knee Surg Sports Traumatol Arthrosc, 2010, 18(6): 710-717.
  6. 6. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg (Br), 1992, 74(2): 228-232.
  7. 7. technique through a mini-incision. Clin Orthop Relat Res, 2007, (464): 32-36.
  8. 8. knee arthroplasty at a minimum of ten years follow-up. J Bone Joint Surg (Am), 2005, 87(5): 999-1006.
  9. 9. trail. J Bone Joint Surg (Br), 2009, 91(1): 52-57.
  10. 10. past, present, and future. Am J Orthop (Belle Mead NJ), 2009, 38(1): 17-23.
  11. 11. knee arthroplasty: survivorship and technical considerations.
  12. 12. at an average follow-up of 12.4 years. J Arthroplasty, 2006, 21(1): 13-17.
  13. 13. Lustig S, Paillot JL, Servien E, et al. Cemented all polyethylene tibial insert.
  14. 14. Naal FD, Neuerburg C, Salzmalm GM, et al. Association of body mass index and clinical outcome 2 years after unicompartmental knee arthroplasty.
  15. 15. Mont MA, Haas S, Mullick T, et al. Total knee arthroplasty for patellofemoral.
  16. 16. 蔣協(xié)遠(yuǎn), 王大偉. 骨科臨床療效評價標(biāo)準(zhǔn). 北京: 人民衛(wèi)生出版社, 2005: 275-277.
  17. 17. Bruni D, Iacono F, Russo A, et al. Minimally invasive unicompartmental.
  18. 18. Argenson JN, O’Connor JJ. Polyethylene wear in meniscal knee replacement.
  19. 19. Psychoyios V, Crawford RW, Murray DW, et al. Wear of congruent mensal bearings in unicompartmental knee replacement. J Bone Joint Surg (Br), 1998, 8(6): 976-982.
  20. 20. Mounasamy V, Sambandam S. Surgical management of young arthritic knee: a review. Eur J Orthop Surg Traumatol, 2008, 18(8): 555-564.
  21. 21. Scott RD, Cobb AG, McQueary FG, et al. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res, 1991, (271): 96-100.
  22. 22. Argenson JN, Parratte S, Flecher X, et al. Unicompartmental knee arthroplasty:.
  23. 23. Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental.
  24. 24. Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospective randomized controlled.
  25. 25. 張催, 陳游, 張春雷, 等. 單髁置換術(shù)與全膝關(guān)節(jié)置換術(shù)治療膝單間室骨性關(guān)節(jié)炎近中期療效的對比研究. 中華關(guān)節(jié)外科雜志(電子版), 2010, 4(2): 26-29.
  26. 26. Jamali AA, Scott RD, Rubash HE, et al. Unicompartmental knee arthroplasty:.
  27. 27. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern uni-compartmental knee arthroplasty with cenmet: a three to ten year follow-up study. J Bone Joint Surg (Am), 2002, 84-A(2): 2235-2239.
  28. 28. Pennington DW, Swienckowski JJ, Lutes WB, et al. Lateral unicompartmental.
  29. 29. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop, 2010, 34(8): 1137-1143.
  30. 30. 高遠(yuǎn)鵬, 紀(jì)斌平, 賈俊青, 等. 單髁置換治療膝關(guān)節(jié)骨性關(guān)節(jié)炎單間室病變. 中國現(xiàn)代醫(yī)生, 2009, 47(16): 48-49.
  31. 31. 胡懿郃, 王賢, 廖前德, 等. 單髁膝關(guān)節(jié)置換治療膝關(guān)節(jié)單間室病變. 中國矯形外科雜志, 2008, 16(3): 161-163.