發(fā)布時(shí)間：2019-06-11 20:40

【摘要】：背景:在臨床工作中,我們遇到了一些通過術(shù)前MRI或術(shù)中關(guān)節(jié)鏡檢查發(fā)現(xiàn)的膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎同時(shí)伴有外側(cè)半月板撕裂的病例。這些病例是否適合采用單髁置換術(shù)(unicompartmental knee arthroplasty,UKA)進(jìn)行治療,外側(cè)半月板是否需要同時(shí)處理,處理后是否會(huì)影響單髁置換術(shù)的臨床效果?目的目的:觀察UKA結(jié)合關(guān)節(jié)鏡下外側(cè)半月板成形術(shù)治療膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎伴有外側(cè)半月板損傷的短期療效。方法方法:2014年1月至2016年1月516例接受UKA患者中,12例(12膝)被證實(shí)(其中7例通過術(shù)前MRI、5例通過術(shù)中關(guān)節(jié)鏡)為內(nèi)側(cè)間室骨關(guān)節(jié)炎伴有膝關(guān)節(jié)外側(cè)半月板損傷,采用常規(guī)關(guān)節(jié)鏡探查及外側(cè)半月板成形術(shù)聯(lián)合UKA治療。回顧性分析這12例患者術(shù)前體征、影像學(xué)資料、手術(shù)情況,采用美國膝關(guān)節(jié)協(xié)會(huì)評(píng)分(KSS評(píng)分)對(duì)術(shù)前、術(shù)后膝關(guān)節(jié)功能進(jìn)行評(píng)估。結(jié)果結(jié)果:關(guān)節(jié)鏡檢查清理時(shí)間平均為12.2 min(10~15 min)。所有患者均獲得了完整的隨訪,平均隨訪時(shí)間為12個(gè)月(6~18個(gè)月),無感染、脂肪栓塞或下肢深靜脈血栓形成,無假體磨損,松動(dòng),脫位和進(jìn)展性骨關(guān)節(jié)炎等并發(fā)癥發(fā)生。末次隨訪患者膝關(guān)節(jié)疼痛消失或明顯減輕,外側(cè)間室半月板損傷癥狀完全消失。術(shù)后KSS膝評(píng)分為(93±5)分,與術(shù)前(53±8)分比較有統(tǒng)計(jì)學(xué)差異(t=21.78,P0.05);術(shù)后KSS功能評(píng)分為(94±6)分,與術(shù)前(55±8)分比較有統(tǒng)計(jì)學(xué)差異(t=24.11,P0.05)。結(jié)論結(jié)論:對(duì)于術(shù)前已經(jīng)明確診斷為內(nèi)側(cè)間室OA同時(shí)伴有外側(cè)半月板損傷的病例,關(guān)節(jié)鏡下外側(cè)半月板成形聯(lián)合UKA術(shù)不會(huì)增加手術(shù)并發(fā)癥及手術(shù)風(fēng)險(xiǎn),短期臨床療效良好。
[Abstract]:Background: in clinical work, we have encountered some cases of medial interventricular osteoarthritis of knee joint with lateral meniscus tear found by preoperative MRI or intraoperative arthroscopy. Are these cases suitable for single condyle replacement (unicompartmental knee arthroplasty,UKA), whether the lateral meniscus needs to be treated at the same time, and whether the clinical effect of unilateral condylar replacement will be affected after treatment? Objective: to observe the short-term effect of UKA combined with lateral meniscus arthroplasty in the treatment of medial interventricular osteoarthritis of knee joint with lateral meniscus injury. Methods: from January 2014 to January 2016, 12 cases (12 knees) of 516 patients with UKA were confirmed to be medial interventricular osteoarthritis with lateral meniscus injury through intraoperative arthroscopy (7 cases through intraoperative arthroscopy). Routine arthroscopic exploration and lateral meniscus angioplasty combined with UKA were used to treat the medial interventricular osteoarthritis with lateral meniscus injury. The preoperative signs, imaging data and surgical conditions of these 12 patients were analyzed retrospectively. the knee joint function before and after operation was evaluated by American knee joint association score (KSS score). Results: the average cleaning time of arthroscopy was 12.2min (10 鈮，

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