• 南方醫(yī)科大學第三附屬醫(yī)院骨科（廣州，510630）;

【摘 要】 目的 評價Oxford Ⅲ單髁系統(tǒng)治療膝關節(jié)內(nèi)側間室退變的中期臨床療效。 方法 2008年12月－2010年8月，收治26例（32膝）膝關節(jié)內(nèi)側間室退變患者，其中11例（14膝）獲2年以上隨訪。男7例（9膝），女4例（5膝）；年齡50～74歲，平均 62.4歲。左側6膝，右側8膝。均為退行性關節(jié)炎，病程5～23年，平均11.6年?；颊呔忻鞔_關節(jié)內(nèi)側間室負重疼痛和壓痛。內(nèi)側間室骨性關節(jié)炎根據(jù)Ahlback分期標準，Ⅱ期4膝，Ⅲ期10膝。膝關節(jié)均伴內(nèi)翻畸形；無主、被動屈伸活動受限。手術取髕內(nèi)側旁切口，采用Oxford Ⅲ單髁系統(tǒng)行膝關節(jié)內(nèi)側間室單髁置換手術。 結果 術后切口均Ⅰ期愈合。術后1～3個月5例出現(xiàn)切口下方局部鵝足疼痛癥狀，給予保守治療，術后6個月復查癥狀均消失。術后11例（14膝）均獲隨訪，隨訪時間24～30個月，平均27.5個月。隨訪期間無假體松動、移位，對側間室和髕股關節(jié)病變、感染等并發(fā)癥發(fā)生。末次隨訪時膝關節(jié)學會評分系統(tǒng)（KSS）評分、美國西部Ontario與McMaster大學骨關節(jié)炎指數(shù)評分（WOMAC）評分、膝關節(jié)活動度與術前比較，差異均有統(tǒng)計學意義（P  lt; 0.05）。末次隨訪時股脛角較術前改善（P  lt; 0.05），但仍為輕度內(nèi)翻；脛骨平臺內(nèi)翻角較術前有所增大，但無統(tǒng)計學意義（P  gt; 0.05）；脛骨內(nèi)髁后傾角明顯較術前減小，差異有統(tǒng)計學意義（P  lt; 0.05）。 結論 OxfordⅢ單髁系統(tǒng)治療膝關節(jié)內(nèi)側間室退變中期療效滿意，創(chuàng)傷小、恢復快；遠期療效尚需進一步觀察。

引用本文： 唐恒濤,趙亮,燕華,金大地,蘇訓同. OxfordⅢ單髁系統(tǒng)治療膝關節(jié)內(nèi)側間室退變的中期療效. 中國修復重建外科雜志, 2012, 26(1): 17-20. doi: 復制

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1. unicompartimental knee arhroplasty: a long term follow-up study. Orthop Traumatol Surg Res, 2009, 95(1): 12-21.
2. Arch Orthop Trauma Surg, 2009, 129(4): 463-468.
3. arthritis. J Bone Joint Surg (Am), 2002, 84-A(11): 1977-1981.
4. knee replacement: retrospective clinical and radiographic evaluation.
5. of 83 patients. Knee Surg Sports Traumatol Arthrosc, 2010, 18(6): 710-717.
6. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg (Br), 1992, 74(2): 228-232.
7. technique through a mini-incision. Clin Orthop Relat Res, 2007, (464): 32-36.
8. knee arthroplasty at a minimum of ten years follow-up. J Bone Joint Surg (Am), 2005, 87(5): 999-1006.
9. trail. J Bone Joint Surg (Br), 2009, 91(1): 52-57.
10. past, present, and future. Am J Orthop (Belle Mead NJ), 2009, 38(1): 17-23.
11. knee arthroplasty: survivorship and technical considerations.
12. at an average follow-up of 12.4 years. J Arthroplasty, 2006, 21(1): 13-17.
13. Lustig S, Paillot JL, Servien E, et al. Cemented all polyethylene tibial insert.
14. Naal FD, Neuerburg C, Salzmalm GM, et al. Association of body mass index and clinical outcome 2 years after unicompartmental knee arthroplasty.
15. Mont MA, Haas S, Mullick T, et al. Total knee arthroplasty for patellofemoral.
16. 蔣協(xié)遠, 王大偉. 骨科臨床療效評價標準. 北京: 人民衛(wèi)生出版社, 2005: 275-277.
17. Bruni D, Iacono F, Russo A, et al. Minimally invasive unicompartmental.
18. Argenson JN, O’Connor JJ. Polyethylene wear in meniscal knee replacement.
19. Psychoyios V, Crawford RW, Murray DW, et al. Wear of congruent mensal bearings in unicompartmental knee replacement. J Bone Joint Surg (Br), 1998, 8(6): 976-982.
20. Mounasamy V, Sambandam S. Surgical management of young arthritic knee: a review. Eur J Orthop Surg Traumatol, 2008, 18(8): 555-564.
21. Scott RD, Cobb AG, McQueary FG, et al. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res, 1991, (271): 96-100.
22. Argenson JN, Parratte S, Flecher X, et al. Unicompartmental knee arthroplasty:.
23. Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental.
24. Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospective randomized controlled.
25. 張催, 陳游, 張春雷, 等. 單髁置換術與全膝關節(jié)置換術治療膝單間室骨性關節(jié)炎近中期療效的對比研究. 中華關節(jié)外科雜志(電子版), 2010, 4(2): 26-29.
26. Jamali AA, Scott RD, Rubash HE, et al. Unicompartmental knee arthroplasty:.
27. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern uni-compartmental knee arthroplasty with cenmet: a three to ten year follow-up study. J Bone Joint Surg (Am), 2002, 84-A(2): 2235-2239.
28. Pennington DW, Swienckowski JJ, Lutes WB, et al. Lateral unicompartmental.
29. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop, 2010, 34(8): 1137-1143.
30. 高遠鵬, 紀斌平, 賈俊青, 等. 單髁置換治療膝關節(jié)骨性關節(jié)炎單間室病變. 中國現(xiàn)代醫(yī)生, 2009, 47(16): 48-49.
31. 胡懿郃, 王賢, 廖前德, 等. 單髁膝關節(jié)置換治療膝關節(jié)單間室病變. 中國矯形外科雜志, 2008, 16(3): 161-163.
  1. 1. unicompartimental knee arhroplasty: a long term follow-up study. Orthop Traumatol Surg Res, 2009, 95(1): 12-21.
  2. 2. Arch Orthop Trauma Surg, 2009, 129(4): 463-468.
  3. 3. arthritis. J Bone Joint Surg (Am), 2002, 84-A(11): 1977-1981.
  4. 4. knee replacement: retrospective clinical and radiographic evaluation.
  5. 5. of 83 patients. Knee Surg Sports Traumatol Arthrosc, 2010, 18(6): 710-717.
  6. 6. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg (Br), 1992, 74(2): 228-232.
  7. 7. technique through a mini-incision. Clin Orthop Relat Res, 2007, (464): 32-36.
  8. 8. knee arthroplasty at a minimum of ten years follow-up. J Bone Joint Surg (Am), 2005, 87(5): 999-1006.
  9. 9. trail. J Bone Joint Surg (Br), 2009, 91(1): 52-57.
  10. 10. past, present, and future. Am J Orthop (Belle Mead NJ), 2009, 38(1): 17-23.
  11. 11. knee arthroplasty: survivorship and technical considerations.
  12. 12. at an average follow-up of 12.4 years. J Arthroplasty, 2006, 21(1): 13-17.
  13. 13. Lustig S, Paillot JL, Servien E, et al. Cemented all polyethylene tibial insert.
  14. 14. Naal FD, Neuerburg C, Salzmalm GM, et al. Association of body mass index and clinical outcome 2 years after unicompartmental knee arthroplasty.
  15. 15. Mont MA, Haas S, Mullick T, et al. Total knee arthroplasty for patellofemoral.
  16. 16. 蔣協(xié)遠, 王大偉. 骨科臨床療效評價標準. 北京: 人民衛(wèi)生出版社, 2005: 275-277.
  17. 17. Bruni D, Iacono F, Russo A, et al. Minimally invasive unicompartmental.
  18. 18. Argenson JN, O’Connor JJ. Polyethylene wear in meniscal knee replacement.
  19. 19. Psychoyios V, Crawford RW, Murray DW, et al. Wear of congruent mensal bearings in unicompartmental knee replacement. J Bone Joint Surg (Br), 1998, 8(6): 976-982.
  20. 20. Mounasamy V, Sambandam S. Surgical management of young arthritic knee: a review. Eur J Orthop Surg Traumatol, 2008, 18(8): 555-564.
  21. 21. Scott RD, Cobb AG, McQueary FG, et al. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res, 1991, (271): 96-100.
  22. 22. Argenson JN, Parratte S, Flecher X, et al. Unicompartmental knee arthroplasty:.
  23. 23. Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental.
  24. 24. Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospective randomized controlled.
  25. 25. 張催, 陳游, 張春雷, 等. 單髁置換術與全膝關節(jié)置換術治療膝單間室骨性關節(jié)炎近中期療效的對比研究. 中華關節(jié)外科雜志(電子版), 2010, 4(2): 26-29.
  26. 26. Jamali AA, Scott RD, Rubash HE, et al. Unicompartmental knee arthroplasty:.
  27. 27. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern uni-compartmental knee arthroplasty with cenmet: a three to ten year follow-up study. J Bone Joint Surg (Am), 2002, 84-A(2): 2235-2239.
  28. 28. Pennington DW, Swienckowski JJ, Lutes WB, et al. Lateral unicompartmental.
  29. 29. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop, 2010, 34(8): 1137-1143.
  30. 30. 高遠鵬, 紀斌平, 賈俊青, 等. 單髁置換治療膝關節(jié)骨性關節(jié)炎單間室病變. 中國現(xiàn)代醫(yī)生, 2009, 47(16): 48-49.
  31. 31. 胡懿郃, 王賢, 廖前德, 等. 單髁膝關節(jié)置換治療膝關節(jié)單間室病變. 中國矯形外科雜志, 2008, 16(3): 161-163.