背景：膝关节单髁置换由于其创伤小、恢复快、并发症低和接近膝关节正常生物力学等优点，在临床上越来越多的被用于修复膝关节单间室疾病。目前国内还没有关于单髁假体角度对生存率影响的报道。目的：观察单髁置换修复膝关节内侧间室骨关节炎随访4-6年的临床疗效。方法：纳入采用Oxford 单髁系统修复膝关节内侧间室骨关节炎的患者30例。观察并发症发生情况；所有患者于置换前、置换后3个月、6个月、1年及每年采用膝关节美国特种外科医院评分评价疗效；通过正位片上胫骨假体与胫骨轴线的关系来确定胫骨假体的内外翻位置，通过侧位片上股骨假体轴线与股骨后缘皮质的关系来确定股骨假体的屈曲或伸直位置。结果与结论：①术后切口均Ⅰ期愈合，无关节感染和下肢深静脉血栓形成等并发症发生；②30例均获随访，随访时间48-72个月，未出现假体松动、脱位及因对侧间室和髌股关节病变而行翻修的病例；③置换后末次随访膝关节美国特种外科医院评分为(90.47±4.05)分；与置换前比较差异有显著性意义(P=0.00)；④单髁假体胫骨侧放置角度：假体轴线与胫骨轴线垂直的21例，内翻放置：2°1例，4°3例，5°2例，6°2例，10°1例，胫骨侧无外翻放置；⑤股骨侧假体放置角度：股骨假体轴线与股骨后缘皮质线平行22例，屈曲位放置：4°2例，5°，6°，7°各1例，伸直位放置：3°，4°，5°各1例；⑥结果表明，单髁置换修复膝关节内侧间室骨关节炎具有较好的初期效果，中远期疗效还需更长时间随访观察。%BACKGROUND:Unicompartment knee replacement is more popular for smal trauma, rapid recovery, low complication and almost normal knee mechanics, and has been more and more used in clinic to repair single compartment knee disease. At present, there is no report about the influence of the angle of the single condyle prosthesis on the survival rate. OBJECTIVE:To evaluate the effectiveness of unicompartmental knee replacement for medial compartmental osteoarthritis of the knee in 4-6 years of fol ow-up. METHODS:Thirty patients with medial compartmental osteoarthritis of the knee were treated by unicompartmental knee replacement with Oxford system. Complication occurrence was observed. Curative effects were evaluated with Hospital for Special Surgery score before and 3 months, 6 months and 1 year after surgery. On anteroposterior view, the varus/valgus alignments of the tibial components were measured relative to the long axis of the tibia. On lateral view, flexion/extension of the femoral component was measured relative to the posterior femoral cortex. RESULTS AND CONCLUSION:(1) Primary healing of incision was obtained in al patients, and no infection or lower limb deep venous thrombosis occurred. (2) Al of the patients were fol owed up for 48-72 months. There was no prosthetic loosening, dislocation or revision for contralateral compartment and patel ofemoral joint symptoms. (3) Hospital for Special Surgery score was significantly increased to (90.47±4.05) (P=0.00). (4) Tibial placement angle of single condyle prosthesis:The axis of the prosthesis was perpendicular to the axis of the tibia in 21 cases. Varus placement:2° in 1 case, 4° in 3 cases, 5° in 2 cases, 6° in 2 cases, and 10° in 1 case. No valgus occurred in the tibial side. (5) Femoral prosthesis placement angle:The axis of the femoral prosthesis was paral el to the posterior edge of the femoral cortex in 22 cases, on the flexed position:4° in 2 cases, 5° in 1 case, 6° in 1 case and 7° in 1 case;in the extension position:3° in 1 case, 4° in 1 case and 5° in 1 case. (6) Results suggested that the unilateral condylar replacement for the repair of medial compartment osteoarthritis of the knee has a good initial effect. The middle-term and long-term efficacy needs longer fol ow-up study.
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