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Title: [Analysis of medial unicompartmental knee arthroplasty for patients with spontaneous osteonecrosis of the knee].
Author: Hu D, Huang Z, Zhang W, Lin J, Li W.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2019 Jan 15; 33(1):13-17. PubMed ID: 30644254.
Abstract:
OBJECTIVE: To analyse the effectiveness of unicompartmental knee arthroplasty (UKA) for the patients with spontaneous osteonecrosis of the knee (SONK). METHODS: Between January 2012 and December 2016, 31 patients with SONK was admitted and treated with medial UKA. All patients were examined by both plain radiography and magnetic resonance images. The patients were composed of 5 men and 26 women with an average age of 64.3 years (range, 48-79 years), and with 16 left joints and 15 right joints. The average disease duration was 14.7 months (range, 6-26 months). Preoperative visual analogue scale (VAS) was 6.00±1.15, Hospital for Special Surgery (HSS) score was 55.77±11.03, and knee range of motion (ROM) was (114.68±10.40)°. The imaging examinations showed that all the lesions were located in the medial compartment of the knee joint and there were 19 patients with Aglietti stage Ⅳ and 12 patients with Aglietti stage Ⅴ. Preoperative femorotibial angle (FTA) was (177.39±1.63)° and posterior tibial slope (PTS) was (84.05±1.39)°. RESULTS: All the incisions healed by first intention. All patients were followed up 14-46 months (mean, 25 months). At last follow-up, VAS score was 2.06±0.72 and HSS score was 86.45±3.67, which both improved significantly when compared with preoperative scores ( t=22.73, P=0.00; t=-14.72, P=0.00). ROM was (118.06±3.80)° with no significant difference when compared with preoperative ROM ( t=-1.78, P=0.08). The X-ray films showed there was no severe adverse events, such as periprosthetic infection, aseptic loosening, bearing dislocation, and so on. At last follow- up, PTS was (85.30±1.19)° with significant difference compared with preoperative one ( t=-4.07, P=0.00); while FTA was (177.51±1.98)° with no significant difference when compared with preoperative FTA ( t=-0.38, P=0.71). CONCLUSION: UKA may be an optional management for SONK with minimally invasive, bone-preserving, and rapid recovery. 目的: 探讨单髁关节置换治疗膝关节自发性骨坏死（spontaneous osteonecrosis of the knee，SONK）的临床疗效。. 方法: 回顾分析 2012 年 1 月—2016 年 12 月，经病理检查确诊为 SONK 且采用牛津第 3 代单髁膝关节假体置换治疗的 31 例患者临床资料。男 5 例，女 26 例；年龄 48～79 岁，平均 64.3 岁。左膝 16 例，右膝 15 例。病程 6～26 个月，平均 14.7 个月。术前膝关节疼痛视觉模拟评分（VAS）为（6.00±1.15）分，美国特种外科医院（HSS）评分为（55.77±11.03）分，膝关节活动度（range of motion，ROM）为（114.68±10.40）°。影像学检查示病变局限于膝关节内侧间室，Aglietti 分期：Ⅳ期 19 例、Ⅴ 期 12 例。膝关节胫股角（femorotibial angle，FTA）为（177.39±1.63）°、胫骨后倾角（posterior tibial slope，PTS）为（84.05±1.39）°。. 结果: 术后切口均Ⅰ期愈合。患者均获随访，随访时间 14～46 个月，平均 25 个月。末次随访时 VAS 评分为（2.06±0.72）分，HSS 评分为（86.45±3.67）分，均较术前显著改善（ t=22.73， P=0.00； t=–14.72， P=0.00）；ROM 为（118.06±3.80）°，与术前比较差异无统计学意义（ t=–1.78， P=0.08）。X 线片复查示随访期间无假体周围感染及假体松动、脱位等并发症发生。末次随访时测量 FTA 为（177.51±1.98）°，与术前比较差异无统计学意义（ t=–0.38， P=0.71）；而 PTS 为（85.30±1.19）°，与术前比较差异有统计学意义（ t=–4.07， P=0.00）。. 结论: 单髁关节置换术治疗 SONK 具有手术创伤小、骨量保留多、术后恢复快等优点，可获得较好的早中期疗效。.

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