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| 微创膝关节单髁置换术治疗合并骨质疏松的内侧间室骨关节炎 |
| Minimally invasive unicondylar knee arthroplasty for the treatment of unicompartmental knee osteoarthritis with osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2012.06.010 |
| 中文关键词: 股骨 骨质疏松 微创 单髁置换术 骨性关节炎 |
| 英文关键词:Femus Osteoporosis Minimal invasive Unicondylar knee arthroplasty Osteoarthritis |
| 基金项目:上海市卫生局局级科研课题（2009218） |
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| 中文摘要: |
| 目的 探讨骨质疏松对膝关节单髁置换术操作和临床效果的影响。方法 回顾性分析2007年1月-2010年12月采用膝关节单髁置换术治疗老年女性膝关节内侧间室骨性关节炎患者47例，其中骨质疏松患者21例，非骨质疏松患者26例。观察切口大小、手术时间、引流量和并发症。采用HSS 评分法对术前、术后膝关节功能进行评估，采用X线摄片对股骨假体力线进行分析。结果 两组患者在切口大小、术后引流量、假体力线上无统计学差异，所有股骨假体大小与股骨髁匹配，骨质疏松组中1例术后X线摄片发现内侧胫骨平台轻度劈裂，但骨折无明显移位，其余患者无感染、脂肪栓塞或下肢深静脉血栓，无假体位置不良。所有患者均获得了完整的随访，术后平均随访24个月(12-60月)。末次随访患者膝关节内侧间室疼痛明显减轻, HSS 评分和膝关节活动度明显增加，无假体位置不良、脱位及假体松动等并发症。结论 老年绝经后女性骨关节炎患者中合并骨质疏松十分常见，通过注意手术技巧术中操作避免使用暴力，术后正规抗骨质疏松治疗，单髁膝关节置换术可获得满意的临床效果和股骨假体力线。 |
| 英文摘要: |
| Objective To explore the effect of osteoporosis on the clinical outcome and surgical technique of minimally invasive unicondylar knee arthroplasty (MI-UKA). Methods The clinical data of 47 patients with MI-UKA for the treatment of unicompartmental knee osteoarthritis from January 2007 to December 2010 were collected, including 21 osteoporosis patients and 26 non-osteoporosis patients. Incision, surgical time, blood loss, and complications were observed. The knee functions before and after the surgery was evaluated with HSS score system. The false physical line of femur was analyzed using X-ray image. Results Patients in the osteoporosis group and non-osteoporosis group had no significant difference in the mean length of incision, the mean blood drainage, and the mean component alignment. All femoral component size was fit. Only one case had mild tibial plateau fracture. The other patients had no complications of infection, fat embolism, deep vein thrombosis, malposition of prosthesis, dislocation, and loosing. All cases were followed up for an average of 24 months (12-60 months). At the last follow up, all cases achieved significant relief of pain, improvement of HSS score, and correction of deformity. Conclusion Osteoporosis is very common in elderly postmenopausal osteoarthritis female patients. MI-UKA can obtain excellent component alignment and clinical results through surgical skills and standard anti-osteoporosis treatment, |
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