单间室膝关节置换术治疗膝关节自发性骨坏死的疗效观察

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Abstract Objective To evaluate the mid-term efficacy of unicompartmental knee arthroplasty(UKA) in the treatment of spontaneous osteonecrosis of the knee(SONK).Methods The patients diagnosed as SONK and received UKA in our hospital from January 2012 to January 2018 were retrospectively analyzed.A total of 28 cases，including 10 males and 18 females，aged from 52 to 73 years，with an average age of (63.0±5.67)years.There were 19 cases(67.9%) in stage Ⅲ and 9 cases (32.1%) in stage Ⅳ according to Mont grades.The patients were diagnosed and staged by X-ray and MRI examine before surgery.The range of motion(ROM)，femorotibial angle(FTA)，visual analog scale(VAS) and the hospital for special surgery(HSS) knee score were recorded.Results All patients completed the operation successfully and were followed up.The average follow-up was (69.0±16.97)months.At the last follow-up，the HSS score was increased from (60.9±2.85) to (91.1±2.57)，P＜0.05；VAS score was decreased from (6.4±0.99) to (1.9±1.0)，P＜0.05；FTA was improved from (178.3±0.88)° to (176.4±0.97)°，P＜0.05；ROM (119.4±5.16)° was not significantly different from that before surgery (119.6±5.30)°，P＝0.601.One patient with large necrotic area developed unexplainable pain after operation，and the symptoms improved after local block injection.Conclusion UKA can be successfully used in the treatment of advanced SONK，the mid-term efficacy is worth affirming，but the long-term survival rate needs further follow-up study.

Key words： spontaneous osteonecrosis unicompartmental knee arthroplasty clinical efficacy

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	Li Hao
	Wang Haohao
	Li Yakun
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Li Hao,Wang Haohao,Li Yakun, et al. Clinical Efficacy of Unicompartmental Knee Arthroplasty in the Treatment of Spontaneous Osteonecrosis of the Knee[J]. sygkzz, 2021, 27(1): 27-32.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2021/V27/I1/27

［1］Ahlbäck S，Bauer GC，Bohne WH，et al.Spontaneous osteonecrosis of the knee［J］.Arthritis Rheum，1968，11(6)：705-733.
［2］Filip AM，Van den Broeck SB.Spontaneous osteonecrosis of the knee (SONK)［J］.JBRBTR，2014，97(4)：268.
［3］Karim AR，Cherian JJ，Jauregui JJ，et al.Osteonecrosis of the knee：review［J］.Ann Transl Med，2015，3(1)：6.
［4］Aglietti P，Insall JN，Buzzi R，et al.Idiopathic osteonecrosis of the knee.Aetiology，prognosis and treatment［J］.J Bone Joint Surg (Br)，1983，65(5)：588-597.
［5］Takao M，Sugano N，Nishii T，et al.Spontaneous regression of steroid-related osteonecrosis of the knee［J］.Clin Orthop Relat Res，2006(452)：210-215.
［6］Chambers C，Craig JG，Zvirbulis R，et al.Spontaneous Osteonecrosis of Knee After Arthroscopy Is Not Necessarily Related to the Procedure［J］.Am J Orthop (Belle Mead NJ)，2015，44(6)：E184-189.
［7］Mont MA，Baumgarten KM，Rifai A，et al.Atraumatic osteonecrosis of the knee［J］.J Bone Joint Surg (Am)，2000，82(9)：1279-1290.
［8］Mont MA，Marker DR，Zywiel MG，et al.Osteonecrosis of the knee and related conditions［J］.J Am Acad Orthop Surg，2011，19(8)：482-494.
［9］Price AJ，Waite JC，Svard U，et al.Longterm clinical results of the medial Oxford unicompartmental knee arthroplasty［J］.Clin Orthop Relat Res，2005(435)：171-180.
［10］Pandit H，Jenkins C，Gill HS，et al.Minimally invasive Oxford phase 3 unicompartmental knee replacement：results of 1000 cases［J］.J Bone Joint Surg (Br)，2011，93(2)：198-204.
［11］彭侃，姚舒馨，马建兵，等.人工单髁膝关节置换术治疗膝骨关节炎［J］.实用骨科杂志，2013，19(2)：106-108.
［12］Price AJ，Webb J，Topf H，et al.Rapid recovery after oxford unicompartmental arthroplasty through a short incision［J］.J Arthroplasty，2001，16(8)：970-976.
［13］逸弘，朱新辉，崔胜宇，等.Oxford Ⅲ单髁置换治疗内侧间室膝关节炎的疗效观察［J］.实用骨科杂志，2017，23(8)：698-702.
［14］O'Connor JJ，Goodfellow JW，Dodd CA，et al.Development and clinical application of meniscal unicompartmental arthroplasty［J］.Proc Inst Mech Eng H，2007，221(1)：47-59.
［15］Bruni D，Iacono F，Raspugli G，et al.Is unicompartmental arthroplasty an acceptable option for spontaneous osteonecrosis of the knee? ［J］.Clin Orthop Relat Res，2012(470)：1442-1451.
［16］Heyse TJ，Khefacha A，Fuchs-Winkelmann S，et al.UKA after spontaneous osteonecrosis of the knee：a retrospective analysis［J］.Arch Orthop Trauma Surg，2011，131(5)：613-617.
［17］Fabre-Aubrespy M，Ollivier M，Pesenti S，et al.Unicompartmental knee arthroplasty in patients older than 75 results in better clinical outcomes and similar survivorship compared to total knee arthroplasty.A matched controlled study［J］.J Arthroplasty，2016，31(12)：2668-2671.
［18］Lunebourg A，Parratte S，Galland A，et al.Is isolated insert exchange a valuable choice for polyethylene wear in metal-backed unicompartmental knee arthroplasty? ［J］.Knee Surg Sports Traumatol Arthrosc，2016，24(10)：3280-3286.
［19］Foran JR，Brown NM，Della Valle CJ，et al.Long-term survivorship and failure modes of unicompartmental knee arthroplasty［J］.Clin Orthop Relat Res，2013(471)：102-108.
［20］Pandit H，Hamilton TW，Jenkins C，et al.The clinical outcome of minimally invasive Phase 3 Oxford unicompartmental knee arthroplasty：a 15-year follow-up of 1000 UKAs［J］.Bone Joint J，2015，97b (11)：1493-1500.
［21］Servien E，Verdonk PC，Lustig S，et al.Medial unicompartimental knee arthroplasty for osteonecrosis or osteoarthritis［J］.Knee Surg Sports Traumatol Arthrosc，2008，16(11)：1038-1042.
［22］Radke S，Wollmerstedt N，Bischoff A，et al.Knee arthroplasty for spontaneous osteonecrosis of the knee：unicompartimental vs bicompartimental knee arthroplasty［J］.Knee Surg Sports Traumatol Arthrosc，2005，13(3)：158-162.
［23］Pape D，Seil R，Fritsch E，et al.Prevalence of spontaneous osteonecrosis of the medial femoral condyle in elderly patients［J］.Knee Surg Sports Traumatol Arthrosc，2002，10(4)：233-240.
［24］Soucacos PN，Xenakis TH，Beris AE，et al.Idiopathic osteonecrosis of the medial femoral condyle.Classification and treatment［J］.Clin Orthop Relat Res，1997(341)：82-89.
［25］Juréus J，Lindstrand A，Geijer M，et al.The natural course of spontaneous osteonecrosis of the knee (SPONK)：a 1-to 27-year follow-up of 40 patients［J］.Acta Orthop，2013，84(4)：410-414.
［26］Ma T，Tu Y，Xue H，et al.Unicompartmental knee arthroplasty for spontaneous osteonecrosis［J］.J Orthop Surg (Hong Kong)，2017，25(1)：1-5.
［27］Malcherczyk D，Figiel J，Hähnlein U，et al.MRI following UKA：The componentbone interface［J］.Acta Orthop Belg，2015，81(1)：84-89.
［28］Langdown AJ，Pandit H，Price AJ，et al.Oxford medial unicompartmental arthroplasty for focal spontaneous osteonecrosis of the knee［J］.Acta Orthop，2005，76(5)：688-692.
［29］Jauregui JJ，Blum CL，Sardesai N，et al.Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee：A meta-analysis［J］.J Orthop Surg (Hong Kong)，2018，26(2)：1-6.
［30］Myers TG，Cui Q，Kuskowski M，et al.Outcomes of total and unicompartmental knee arthroplasty for secondary and spontaneous osteonecrosis of the knee［J］.J Bone Joint Surg (Am)，2006，88 (Suppl 3)：76-82.
［31］Parratte S，Argenson JN，Dumas J，et al.Unicompartmental knee arthroplasty for avascular osteonecrosis［J］.Clin Orthop Relat Res，2007(464)：37-42.
［32］Choy WS，Kim KJ，Lee SK，et al.Medial unicompartmental knee arthroplasty in patients with spontaneous osteonecrosis of the knee［J］.Clin Orthop Surg，2011，3(4)：279-284.
［33］Guo WS，Zhang QD，Liu ZH，et al.Minimally invasive unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee［J］.Orthop Surg，2015，7(2)：119-124.
［34］Tírico LEP，Early SA，McCauley JC，et al.Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee：A Case Series［J］.Orthop J Sports Med，2017，5(10)：1-6.
［35］Yasuda T，Ota S，Fujita S，et al.Association between medial meniscus extrusion and spontaneous osteonecrosis of the knee［J］.Int J Rheum Dis，2018，21(12)：2104-2111.
［36］Xue H，Tu Y，Ma T，et al.Up to twelve years follow-up of the Oxford phase three unicompartmental knee replacement in China：seven hundred and eight knees from an independent centre［J］.Int Orthop，2017，41(8)：1571-1577.

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