LINK固定平台单髁置换术治疗膝单间室骨关节炎的临床研究

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Objective To investigate the clinical efficacy of Link fixed-bearingunicompartmental knee arthroplasty(UKA) in the treatment of medial knee osteoarthritis (KOA). Methods We choose 55 patients who had Link fixed-bearing unicompartmental knee arthroplasty from March 2014 to May 2016 in Guangdong Provincial Hospital of Traditional Chinese Medicine，including 25 males (25 knees) and 30 females (30 knees).The average age was 67 (53～81).The average weight was 64kg (45～83 kg). The patients were followed up for 12～26 months with an average of 15.6 months.All cases completed by the same surgeon，using a fixed platform Link unicompartmental prosthesis system line medial condyle replacement，and minimally invasiving UKA take small incision technique.The patients were collected for statistical analysis of the operation time，blood loss，postoperative hospital stay，hospitalization costs and other data.To observe the occurrence of postoperative complications after UKA surgery.Before and after surgery，the anterior lateral knee joint X-ray and full-length negative double-arm X-ray were performed.The preoperative and postoperative femorotibial angle (FTA)，hip-knee-ankle angle (HKA) and range of motion (ROM) of the knee joint were measured. And at the time of the last follow-up，the hospital's special surgery knee score (HSS score)，the American Knee Association score were evaluation.Data were processed and statistically analyzed using SPSS 18.0 software (P＜0.05 was considered statistically significant).Results The average operation time of 55 patients (55 knees) was 89.36 min.The mean intraoperative blood loss was 50.71 mL.The average length of postoperative hospital stay was 7.5 days and the average cost of hospitalization was 37 768.5 yuan.All patients underwent surgical resection with grade A healing without infection.Perioperative complications such as pulmonary embolism，deep venous thrombosis of lower extremities，iatrogenic neurovascular injury and periprosthetic fracture occurred.Average follow-up 15.6 months (12～26 months)，patients with quality of life was significantly improved compared with preoperative，all cases were no sterile prostheses loosening，unexplained pain，polyethylene liner dislocation and other complications.The preoperative HKA was (173.6±3.5)° and postoperatively(177.5±1.4)°.The average preoperative FTA was (180.5±4.2)° and the average postoperative period was (175.4 ± 5.8)°.The maximal knee joint activity increased from preoperative (94.5±8.1)° to postoperative (113.7±7.8)°.The above data，preoperative and postoperative compared，the differences were statistically significant (P <0.05).KSS functional scores were (58.7±7.8)° and (86.4±6.8)° .The HSS scores of knee joint at preoperative and final follow-up were respectively(46.5±5.8)° and (85.7±8.7)°.Compared the data from last follow-up with that before surgery，there were statistically difference in the three groups(P＜0.05).Conclusion Unicompartmental arthroplasty with link Sled fixed-bearing single condylar prosthesis and minimally invasive single condylar technique is a good option for patients with osteoarthritis of the medial compartment of the knee.The reseans includ small trauma，less bone resection，shorter operation time，less blood loss，shorter postoperative hospitalization time，less complication，quicker postoperative recovery ，greater joint activity，better body feelings and so on.The short-term effect is satisfactory，the alignment of lower limbs is improved obviously，and its long term effect needs further observation.

Key words： unicompartmental arthroplasty fixed platform knee osteoartheitis

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