部分膝人工关节对膝关节自发性坏死治疗.pptVIP

部分膝人工关节对膝关节自发 性坏死治疗  introductⅰon Osteonecrosis of the knee First described by ahlback et al. in 1968 Classification of knee osteonecrosis 1. Spontaneous osteonecrosis of knee(SoNK) 2. Secondary osteonecrosis 3. Post-arthroscopic osteonecrosis MACKAY MEMORIAL HOSPITAL  Characteristic Secondary ON SONK Postarthroscopic ON Sex Male Femal Female Male No predilection Bilaterality 80%, both condyles5%,most Other joint involvment Hip, shoulder, ankle No Associated risk factor Direct: trauma Idiopathic, chronic Arthroscopic chemotherapy mechanical stress meniscectomy, Indirect: alcholism or micro-trauma cartilage debridement, ACL smoKIng econstruction MACKAY MEMORIAL HOSPITAL  SONK: Clinical presentation and diagnosis Acute knee pain, worse at night or weight-bearing Typical radiographic finding of SonK radiolucenicies or flattening of the affected condyle MRI: detection of earlier stage of knee osteonecrosis Crescentia MACKAY MEMORIA  · Treatment for sonK Non-surgica NSAIDs, protected weight-bearing, Bisphosphonate Surgical: Joint-preserving arthroscopic debridement, core decompresion, tibia osteotomy, Arthroplasty: TKA or UKA MACKAY MEMORIAL HOSPITAL  New concepts for sonK pathogenes Medial meniscus posterior root tear MMPRT) is associated with the cartilage damage of the knee Cartilage loss knee joint pressureN  Subchondral insufficiency fracture with edema Necrosis MMPRT is a critical factor in the development of sonk and knee osteoarthritis MACKAY MEMORIAL HOSPITAL  Aims of this study 1. The result of uni-knee arthroplasty(uKa)treatment for SoNK in our hospita 2. the incidence of MMPRT in confirmed diagnosis SoNK patient MACKAY MEMORIAL HOSPITAL  Method and materials 81 patients with UKA since Jan 2013-Dec 2017 42 patient had final diagnosis with SONK 81 patient had 23 patient with MRI-proved Prognosis evaluation Oxford knee score(Pre-op/Post-op VAS pain score 42 SONK compartment OA ROM 19 pati