摘要目的 对比单髁置换术治疗膝关节自发性骨坏死与膝关节内侧骨关节炎的临床疗效。方法 回顾性分析我科2017年1月至2019年1月使用单髁关节置换术治疗符合诊断的膝关节自发性骨坏死(spontaneous osteonecrosis of the knee,SONK)患者20例20膝(SONK组),男4例,女16例,年龄61~83岁,平均(71.9±8.2)岁。根据年龄、性别、身体质量指数筛选出相匹配的同期使用单髁置换术治疗膝关节内侧骨关节炎(medial compartment osteoarthritis,MOA)患者20例20膝(MOA组),男4例,女16例,年龄63~79岁,平均(72.5±8.2)岁。记录两组术后并发症发生情况、术前及末次随访时美国特种外科医院膝关节评分(hospital for special surgery,HSS)、牛津大学膝关节评分(Oxford knee score,OKS)、膝关节最大活动度(range of motion,ROM)、股胫角、髋膝踝角。结果 40例均获随访,随访时间12~32个月,平均(24.2±17.4个)个月,骨坏死组1例出现假体松动,骨关节炎组1例出现不明原因疼痛,两组患者皆无感染、深静脉血栓形成等并发症发生。两组患者末次随访时膝关节OKS评分、KSS评分、膝关节活动度均较术前明显改善,差异有统计学意义(P<0.05),但组间对比差异无统计学意义(P>0.05);SONK组股胫角、髋膝踝角均较术前明显改善,差异有统计学意义(P<0.05)。结论 单髁置换术治疗膝关节自发性骨坏死具有创伤小、术后恢复快、术后本体感觉存在等优点,中短期疗效满意,与治疗膝关节内侧骨关节炎具有相似的临床疗效。
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