微创人工膝关节单髁置换治疗膝骨性关节炎临床疗效剖析.docVIP

微创人工膝关节单髁置换治疗膝骨性关节炎临床疗效剖析 　　【摘要】 目的：探?微创人工膝关节单髁置换治疗膝关节骨性关节炎短期临床疗效及手术技巧。方法：回顾性分析2014年4月-2016年3月本科收治膝关节骨性关节炎内侧间室严重病变患者18例，所有患者行微创人工膝关节单髁置换术，记录手术时间、术中出血量、术前及术后血红蛋白变化、术后切口感染、膝关节假体松动、下沉、假体周围骨折、髌前疼痛、膝关节屈曲及内翻畸形矫正等情况，采用HSS膝关节功能评分对术前及术后膝关节功能进行评价。结果：所有患者术后均获得随访，随访时间6～23个月，平均14.6个月。膝关节内侧疼痛缓解，除1例出现关节感染，其他无假体松动、下沉、假体周围骨折、膝关节髌前疼痛等发生。术前膝关节屈曲角度100°～110°，术后120°～135°；术前内翻角度0°～9°，术后0°～3°；术前HSS评分为70分，术后为93分，优良率94%。本组病例手术时间60～100 min，平均（82.00±5.62）min；术中出血量80～260 mL，平均（150.00±40.67）mL；术前血红蛋白115～132 g/L，平均124.3 g/L，术后106～127 g/L，平均118.2 g/L。本组患者手术前后各观察指标比较，差异均有统计学意义（P0.05）。结论：在严格掌握适应证情况下，微创膝关节单髁置换治疗膝关节内侧间室病变骨性关节炎患者手术创伤小，手术时间短，术中出血少，术后隐性失血少，屈曲挛缩及内翻畸形矫正明显，保留骨量多，并发症少，是一种不错的选择。 　　【关键词】 膝关节； 骨性关节炎； 单髁置换 　　【Abstract】 Objective：To investigate the short-term clinical efficacy and surgical techniques of minimally invasive unicondylar knee arthroplasty in the treatment of knee osteoarthritis.Method：18 cases of severe lesions in the medial compartment of the knee joint osteoarthritis in our department were retrospective analyzed from April 2014 to March 2016.All patients were given minimally invasive unicondylar knee arthroplasty，the operation time，intraoperative blood loss，preoperative and postoperative hemoglobin levels，postoperative incision infection，knee joint prosthesis loosening，sinking，periprosthetic fracture，anterior knee pain，knee flexion and varus deformity correction were recorded.The function of knee joint was evaluated by HSS knee function score before and after operation.Result：All patients were followed up for 6-23 months，average 14.6 months.Medial knee pain relief，in addition to 1 case joint infection occurred，no cases of prosthesis loosening， sinking，periprosthetic fracture and anterior knee joint pain happen.Preoperative knee flexion angle of 100°-110°，postoperative of 120°-135°；preoperative varus angle of 0°-9° and postoperative was 0°-3°；preoperative HSS score were 70 points，postoperative were 93 points，good rate of 94%.The operative time was 60-100 min，average（82.00±5.62）m