CAJ | 학술논문

目的：探讨单髁关节置换术（UKA）在膝骨关节炎中的运用和疗效。方法选取2007年4月至2013年8月在济南军区总医院骨病科行单髁关节置换术的161例患者（共182膝），其中男41例，女120例；年龄40～82岁，平均年龄63．4岁；体重58．3～73．9 kg，平均体重65．1 kg。术前行膝关节负重正侧位、双下肢全长正位及髌骨轴位X线片检查。测量术前术后膝关节活动度，采用视觉模拟评分（ VAS）、美国膝关节协会评分（ KSS）及膝关节活动度评分等指标对膝关节进行评估与分析。结果其中141例（共160膝）患者获得良好随访，无感染、深静脉血栓形成，2例患者术后发生衬垫脱位；1例股骨髁假体松动并衬垫脱位；1例股骨髁假体位置异常，术后反复出现关节绞锁，后行切开探查调整股骨髁假体后恢复正常。随访时间3～60个月，平均2年。 KSS评分术前为（60．5±2．7）分，术后为（93．1±1．1）分，手术前后的KSS评分差异有统计学意义（P＜0．05）；VAS评分术前为（6．7±1．1）分，术后为（2．6±0．9）分，手术前后的VAS评分差异有统计学意义（ P＜0．05）；膝关节屈曲度术前平均（100．3±2．6）°，术后平均（127．5±3．2）°，手术前后的差异有统计学意义（ P ＜0．05）。结论在治疗膝内侧间室骨关节炎上，UKA是一种创伤小、恢复快及疗效显著的治疗方法，但中远期疗效有待进一步的随访和研究。
목적：탐토단과관절치환술（UKA）재슬골관절염중적운용화료효。방법선취2007년4월지2013년8월재제남군구총의원골병과행단과관절치환술적161례환자（공182슬），기중남41례，녀120례；년령40～82세，평균년령63．4세；체중58．3～73．9 kg，평균체중65．1 kg。술전행슬관절부중정측위、쌍하지전장정위급빈골축위X선편검사。측량술전술후슬관절활동도，채용시각모의평분（ VAS）、미국슬관절협회평분（ KSS）급슬관절활동도평분등지표대슬관절진행평고여분석。결과기중141례（공160슬）환자획득량호수방，무감염、심정맥혈전형성，2례환자술후발생츤점탈위；1례고골과가체송동병츤점탈위；1례고골과가체위치이상，술후반복출현관절교쇄，후행절개탐사조정고골과가체후회복정상。수방시간3～60개월，평균2년。 KSS평분술전위（60．5±2．7）분，술후위（93．1±1．1）분，수술전후적KSS평분차이유통계학의의（P＜0．05）；VAS평분술전위（6．7±1．1）분，술후위（2．6±0．9）분，수술전후적VAS평분차이유통계학의의（ P＜0．05）；슬관절굴곡도술전평균（100．3±2．6）°，술후평균（127．5±3．2）°，수술전후적차이유통계학의의（ P ＜0．05）。결론재치료슬내측간실골관절염상，UKA시일충창상소、회복쾌급료효현저적치료방법，단중원기료효유대진일보적수방화연구。
Objective To explore the application and clinical effects of unicompartmen talknee arthroplasty ( UKA) in the treatment of osteoarthritis.Methods From 2007.4 to 2013.8, 161 patients (182 knees) with medial compartment osteoarthritis were treated by UKA in department of orthopedics, General Hospital of Jinan military area, consisting of 41 males,120 females, mean age 63.4 years ( range 40-82 years ) , mean weight 65.1 kg ( range 58.3 -73.9 kg ) . The preoperative X-ray included anteroposterior and lateral images of the knee joint, full-length image of the lower limb, and the patella-axial view.The preoperative and postoperative knee activity tests, American knee society knee score ( KSS) and visual analog score ( VAS) of knee joint were evaluated and analyzed.Results All the cases were followed up for 3-60 months ( two years in average ) .No infection or deep venous thrombosis was observed;two cases developed dislocation of the prosthesis bearing;one case developed femoral condylar prosthesis loosening and dislocation of the prosthesis bearing;one case developed malposition of the femoral condylar prosthesis.As for the preoperative data and the postoperative data, the differences in joint flexion ability[preoperative (100.3 ±2.6)°vs postoperative (127.5 ±3.2)°,P<0.05], KSS score[preoperative (60.5 ±2.7)vs (93.1 ±1.1) at last follow-up,P<0.05)] and VAS score[(preoperative (6.7 ±1.1) vs ( 2.6 ±0.9 ) at last follow-up, P <0.05 ) ] were significant.Conclusion In the treatment of medial compartment osteoarthritis, UKA has advantages such as less trauma, fewer complications and rapid recovery,but its mid and long term efficacy still needs further follow-up and research.