前交叉韧带磁共振异常患者行单髁置换的临床疗效分析

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摘要目的探讨术前MRI提示前交叉韧带信号异常的患者行内侧活动平台膝关节单髁置换术(unicompartmental knee arthroplasty，UKA)的临床疗效.方法回顾性分析苏州市立医院关节外科2019年1月至2021年12月收治的采用UKA治疗膝骨关节炎患者资料61例。61例患者术前MRI中30膝ACL正常，31膝ACL异常，分为ACLMRI正常组，ACL-MRI异常组。ACL-MRI正常组30例，男9例，女21例；年龄67~85岁，平均(72.03±1.57)岁；左膝15例，右膝15例。ACL-MRI异常组31例，男11例，女20例；年龄65~80岁，平均(71.87±1.37)岁；左膝14例，右膝17例。两组采用美国特种外科医院(hospital for special surgery，HSS)膝关节评分、疼痛视觉模拟评分(visual analogue scale，VAS)、膝关节活动度(range of motion，ROM)对术前及末次随访时膝关节状态进行评估，观察两组术后膝关节假体松动、感染、垫片移位及磨损等情况，并记录术后并发症。结果 61例患者均获得随访，随访时间22~24个月，平均(23.86±0.57)个月。两组术后膝关节HSS评分、ROM、VAS评分较术前均有明显改善，差异有统计学意义(P＜0.05)；两组术后膝关节HSS评分、ROM、VAS评分比较，差异无统计学意义(P＞0.05)。两组术后均未出现假体感染或松动、垫片移位、深静脉血栓等并发症。结论术前MRI中ACL表现异常但术中探查功能性完好的患者行UKA短期临床疗效满意，但长期结果还需要进一步随访研究。

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	刘宇博
	郭东昇
	虞宵
	徐人杰
	李索远
	陈广祥
	张向鑫

关键词 ：前交叉韧带, 膝关节单髁置换术, 核磁共振

Abstract：Objective To investigate the clinical efficacy of mobilebearing unicompartmental knee arthroplasty(UKA) in patients with magnetic resonance imaging(MRI) indicating abnormal signal of the anterior cruciate ligament.Methods Retrospective analysis was made on the patients with knee Articular bone treated with single condylar replacement from January 2019 to December 2021 in the Joint Surgery Department of Suzhou Municipal Hospital.According to the preoperative MRI ACL manifestations，61 patients were divided into a normal ACL group with 31 patients and an abnormal ACL group with 30 patients.The normal ACLMRI group，including 9 males and 21 females.The age ranged from 67 to 85 years，with an average of (72.03±1.57)years.There are 15 left knees and 15 right knees in the normal group.The ACL-MRI abnormal group included 11 males and 20 females.The age ranged from 65 to 80 years，with an average of (71.87±1.37)years.There were 14 left knees and 17 right knees in the abnormal group.The two groups were evaluated for preoperative and final follow-up knee joint status using the HSS，VAS and knee joint range of motion (ROM).We observed whether there were postoperative complications such as looseness，infection，displacement and wear of the knee joint prosthesis in two groups after surgery.Results All 61 patients were followed up for 22 months to 24 months with an average follow-up time of (23.86±0.57)months.Both groups showed significant improvement compared with preoperative status，including knee joint HSS and knee joint range of motion.There was no statistically significant difference in VAS(P＞0.05).There were no postoperative complications such as infection or loosening of prosthesis，pad displacement，deep vein thrombosis in both groups.Conclusion Short-term clinical efficacy of UKA in patients with abnormal preoperative ACL magnetic resonance imaging but intact function is satisfactory.However，further follow-up research is needed for long-term results.

Key words： anterior cruciate ligament unicompartmental knee arthroplasty magnetic resonance imaging

基金资助:苏州市科教兴卫青年科技项目(kjxw2021034)

通讯作者: 张向鑫

作者简介: 刘宇博(1988－ )，男，主治医师，南京医科大学姑苏学院，苏州市立医院关节外科，835572535@qq.com

引用本文:

刘宇博，郭东昇，虞宵，徐人杰，李索远，陈广祥，张向鑫. 前交叉韧带磁共振异常患者行单髁置换的临床疗效分析[J]. 实用骨科杂志, 2023, 29(10): 877-.
Liu Yubo，Guo Dongsheng，Yu Xiao，Xu Renjie，Li Suoyuan，Chen Guangxiang，Zhang Xiangxin. Follow-Up Analysis of Unicompartmental Knee Arthroplasty in Patients with Abnormal Anterior Cruciate Ligament On MRI. sygkzz, 2023, 29(10): 877-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I10/877

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