摘要目的 探讨单髁置换术(unicompartmental knee arthroplasty，UKA)治疗膝前内侧骨关节炎的临床疗效。方法 回顾性分析我科2012年6月至2017年6月使用Oxford Ⅲ UKA治疗符合诊断的膝前内侧骨关节炎患者45例(47膝)，所有患者均获随访。记录术中失血量、手术时间、伤口引流量、术后并发症发生情况，比较术前及末次访时膝关节最大活动度(range of motion，ROM)、牛津膝关节评分(Oxford knee score，OKS评分)、美国特种外科医院膝关节评分(hospital for special surgery knee score，HSS评分)、西安大略和麦柯玛斯大学骨关节评分(western Ontario and MacMaster score，WOMAC评分)，分析Oxford Ⅲ UKA的临床疗效。结果 术后患者均恢复良好，无感染、深静脉血栓形成等并发症。术中平均失血量(95.8±17.5)mL；平均手术时间(83.8±12.1)min；伤口平均引流量为(154.3±32.5)mL。随访时间6～58个月，平均25.6个月，随访期间无假体松迹象、聚乙烯衬垫脱位及进展为外侧间室骨关节炎等出现，仅1例患者出现不明原因疼痛。末次随访时膝关节ROM、OKS评分、HSS评分、WOMAC评分均较术前明显改善，差异有统计学意义(P＜0.05)。结论 单髁置换术治疗膝前内侧骨关节炎具有手术创伤小、术后恢复快、术后本体感觉存在等优点，近期疗效满意，但中远期疗效有待进一步观察。
Abstract：Objective To evaluate the clinical efficacy of UKA in the treatment of anteromedial osteoarthritis(AMAO).Methods Clinical data of 45 patients (47 knees) who underwent OxfordⅢunicompartmental knee arthroplasty from June 2014 to June 2017 in our dept were retrospectively analyzed.The intraoperative blood loss，operation time，postoperative drainage volume and complications were recorded.The knee joint range of motion(ROM)，Oxford knee score(OKS)，hospital for special surgery score (HSS) and Western Ontario and MacMaster score(WOMAC) were recorded before operation and after operation to analysis the clinical efficacy of Oxford Ⅲ UKA.Results Patients with good recovery after surgery and no complications such as infection and deep venous thrombosis happened. The average intraoperative blood loss was (95.8±17.5)mL，the average operation time was (83.8±12.1)min，the average postoperative drainage volume was (154.3±32.5)mL.The average follow-up time were 25.6 months(6～58 months)，and there were no sign of prosthesis loosening，polyethylene liner dislocation and progressing the lateral compartment osteoarthritis，only one case with unexplained pain happened during follow-up.Compared with preoperative ones，the last follow-up ROM，OKS，HSS，WOMAC scores were obviously improved (P＜ 0.05).Conclusion UKA is an effective procedure for AMAO with less trauma，rapid recovery and proprioception exist.The short-term clinical efficacy is satisfied，but long-term efficacy remains to be seen.
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