Study on the Short and Medium Term Efficacy of Single Condyle Replacement Combined with Autologous Osteochondral Graft in the Treatment of Bicompartment Osteoarthritis
Department of Orthopaedics，Wangjing Hospital of China Academy of Chinese Medical Sciences
Abstract：Objective To observe the short and medium term clinical efficacy of medial unicompartmental knee arthroplasty (UKA) combined with autologous osteochondral transplantation in the treatment of two-compartment osteoarthritis of knee joint.Methods A retrospective analysis has been performed on 22 patients from June 2018 to September 2019 in Orthopaedics Department of Wangjing Hospital of China Academy of Chinese Medical Sciences.6 male cases and 16 female cases were included.The age ranged from 53 to 64，with an average of 58.The patients with two-compartment osteoarthritis of the knee were treated with UKA combined with autologous osteochondral transplantation.Imaging data before and after surgery were collected，and visual analogue VAS scores，American knee society score(KSS) scores and complications were recorded before and 3，6 and 12 months after surgery.Results All patients have been followed up for 18 ~ 26 months.(1)Compared with the operation，intraarticular angulation，varus deformity Angle and knee posterior inclination Angle were significantly decreased after operation，and the differences were statistically significant (P＜0.05).(2)Knee pain and functional activity were significantly improved after surgery，and the final score was significantly increased，with statistical significance (P＜0.05).(3)In postoperative follow-up，only 1 patient had joint instability and recovered well after treatment.Conclusion UKA combined with autologous osteochondral transplantation has the best clinical efficacy in early and middle stage for patients with severe medial knee osteoarthritis complicated with mild patellofemoral joint.
汤吉祥，荆琳，张洪美，艾奇，闫奇，潘丽，刘思冶，李彦. 单髁置换联合自体骨软骨移植治疗双间室骨关节炎的中短期疗效研究[J]. 实用骨科杂志, 2022, 28(10): 898-.
Tang Jixiang，Jing Lin，Zhang Hongmei，Ai Qi，Yan Qi，Pan Li，Liu Siye，Li Yan. Study on the Short and Medium Term Efficacy of Single Condyle Replacement Combined with Autologous Osteochondral Graft in the Treatment of Bicompartment Osteoarthritis. sygkzz, 2022, 28(10): 898-.
［1］胡海鹰，陈雪梅，丁倩，等.膝骨关节炎的研究进展［J］.中国社区医师，2020，36(32)：8-9.
［2］刘军.中西医结合治疗膝骨关节炎的优势［J］.中国中西医结合杂志，2021，41(7)：775-777.
［3］Katz JN，Arant KR，Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis：A review［J］.JAMA，2021，325(6)：568-578.
［4］徐海军，陈明，程文俊，等.单髁膝关节置换治疗外侧室骨关节炎［J］.中国矫形外科杂志，2020，28(22)：2095-2097.
［5］Greco NJ，Lombardi Jr AV，Hurst JM，et al.Medial unicompartmental knee arthroplasty for the treatment of focal femoral osteonecrosis［J］.JBJS，2019，101(12)：1077-1084.
［6］Murray DW，Parkinson RW.Usage of unicompartmental knee arthroplasty［J］.Bone Joint J，2018，100(4)：432-435.
［7］冯重阳，姬振伟，吴鹏，等.膝关节单髁置换术的研究进展［J］.实用骨科杂志，2022，28(6)：528532.
［8］Kraeutler MJ，Belk JW，Purcell JM，et al.Microfracture versus autologous chondrocyte implantation for articular cartilage lesions in the knee：A systematic review of 5 year outcomes［J］.Am J Sports Med，2018，46(4)：995-999.
［9］黄福均，王聪聪，张益民，等.关节镜下自体骨软骨移植治疗股骨负重区软骨缺损的疗效分析［J］.现代医药卫生，2021，37(9)：1442-1444.
［10］王声雨，林源，陶树清.中老年人膝骨关节炎的影响因素分析［J］.中国医药导报，2021，18(27)：80-83.
［11］魏亮，付志厚，孙海宁，等.Oxford单髁置换术治疗老年膝内侧间室骨关节炎早中期临床疗效［J］.生物骨科材料与临床研究，2021，18(2)：55-58.
［12］Bruce DJ，Hassaballa M，Robinson JR，et al.Minimum 10 year outcomes of a fixed bearing all-polyethylene unicompartmental knee arthroplasty used to treat medial osteoarthritis［J］.The Knee，2020，27(3)：1018-1027.
［13］Kievit AJ，Kuijer PPF，de Haan LJ，et al.Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty［J］.Knee Surgery，Sports Traumatology，Arthroscopy，2020，28(9)：2905-2916.
［14］李发东，孟刚，赵永胜，等.单髁置换与全膝置换治疗内侧间室膝骨关节炎的早期疗效对比［J］.实用骨科杂志，2019，25(6)：557-560.
［15］张江涛，尚延春，李启义，等.全膝关节置换术与单髁置换术治疗内侧间室膝骨关节炎疗效对比的meta分析［J］.中华骨与关节外科杂志，2020，13(10)：830-835.
［16］卢明峰，李泽晖，朱东平，等.同一患者双膝单间室骨关节炎单髁置换与全膝关节置换的对比［J］.中国组织工程研究，2018，22(3)：343-349.
［17］吴东，杨敏之，曹正，等.膝关节单髁置换术研究进展［J］.中国修复重建外科杂志，2020，34(2)：145-150.
［18］林雪峰，支晓阳.GeneXpertMTB/RIF实时荧光定量PCR系统在肺结核诊断及利福平耐药检测中的应用［J］.中国卫生检验杂志，2017，27(6)：853-856.
［19］黄福均，王聪聪，张益民，等.关节镜下自体骨软骨移植治疗股骨负重区软骨缺损的疗效分析［J］.现代医药卫生，2021，37(9)：1442-1444.
［20］辛龙，张春，徐卫星，等.膝关节软骨损伤的外科治疗进展［J］.中国骨伤，2018，31(3)：5.
［21］黄福均，张益民，王军，等.膝关节软骨损伤的治疗进展［J］.生物骨科材料与临床研究，2021，18(6)：4.
［22］Pareek A，Reardon PJ，Macalena JA，et al.Osteochondral autograft transfer versus microfracture in the knee：A meta-analysis of prospective comparative studies at midterm［J］.Arthroscopy，2016，32(10)：2118-2130.
［23］Cetinkaya S，Toker B，Taser O.Arthroscopic retrograde osteochondral autologous transplantation to chondral lesion in femoral head［J］.Orthopaedics，2014，37(6)：e600-e604.
［24］Wajsfisz A，Makridis KG，Djian P.Arthroscopic retrograde osteochondral autograft transplantation for cartilage lesions of the tibial plateau：A prospective study［J］.Am J Sport Med，2013，41(2)：411-415.
［25］Ronga M，Stissi P，La Barbera G，et al.Treatment of unstable osteochondritis dissecans in adults with autogenous osteochondral grafts(Mosaicplasty)：Long-term results［J］.Joints，2015，3(4)：173-178.
［26］Nishizawa Y，Matsumoto T，Araki D，et al.Matching articular surfaces of selected donor and recipient sites for cylindrical osteochondral grafts of the femur：Quantitative evaluation using a 3-dimensional laser scanner［J］.Am J Sports Med，2014，42(3)：658-664.
［27］Gudas R，Kalesinskas RJ，Kimtys V，et al.A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes［J］.Arthroscopy，2005，21(9)：1066-1075.
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