单髁置换治疗膝关节前内侧单间室骨性关节炎

发布时间：2018-03-21 16:17

本文选题：膝关节　切入点：骨关节炎　出处：《中国组织工程研究》2017年19期 　论文类型：期刊论文

【摘要】：背景:膝关节单髁置换始于20世纪70年代,早期曾由于术后返修率高而一度被关节外科医生所否定。目前治疗膝关节早期单间室骨性关节炎的方法有膝关节单髁置换、全膝关节置换胫骨高位截骨术和腓骨截断术等。经近几年大量的文献报道及回顾性研究证实膝关节单髁置换在治疗膝关节单间室骨性关节炎疗效肯定,并较其他手术方式具有独特的优势。目的:综述单髁置换治疗膝关节前内侧单间室骨性关节炎适应证、禁忌证、手术曲线、手术过程、技术要点及临床疗效等方面的现状及研究进展。方法:第一作者检索至2006年3月至2016年9月为止Pub Med数据(http://www.ncbi.nlm.nih.gov/Pub Med)及CNKI相关期刊论文(http://www.cnki.net/),以"Unicompartmental knee arthroplasty,knee,osteoarthritis,clinical application"为英文检索词,"单髁置换,膝关节,骨性关节炎"为中文检索词,总计中英文文献95篇,40篇文献符合纳入标准。结果与结论:膝关节单髁置换仅对膝关节早期单间室骨性关节炎进行单侧病变间室表面置换,用以替代膝关节胫股关节破坏的软骨表面并具有创伤少、恢复快、并发症少、术后关节本体感觉存在及患者接受度高的优点。但由于其患者选择要求较高,其手术适应证范围较全膝关节置换狭窄而限制其手术的开展;同时全膝关节置换手术技术较成熟,远其疗效肯定。膝关节单髁置换在国内开展相对较晚,开展范围还不是很普遍,其远期临床疗效有待于进一步临床验证。但如果能准确的把握手术适应证,选择合适的患者,精心的术前准备、熟练的手术操作临床效果还是令人满意的。随着假体和器械设计的改进,手术技术的进步膝关节单髁置换应用于膝关节前内侧间室骨性关节炎具有广阔的前景。
[Abstract]:Background: single condylar knee arthroplasty began in 1970s and was once denied by joint surgeons in the early stage due to the high rate of postoperative repair. The current treatment for early single-compartment osteoarthritis of the knee is single condylar replacement of the knee. Total knee arthroplasty high tibial osteotomy and fibula amputation etc. In recent years, a large number of literature reports and retrospective studies have confirmed that single condylar replacement of knee joint is effective in the treatment of single compartment osteoarthritis of the knee. Objective: to review the indications, contraindications, surgical curves, surgical procedures and procedures of single condylar replacement in the treatment of anterior medial single compartment osteoarthritis of the knee. Methods: the first author searched the Pub Med data from March 2006 to September 2016 (http: / / www.ncbi.nlm.nih.gov/ Pub Med) and CNKI China Journal full-text database http: / / www.cnki.netr.Http1: / / www.cnki.netr.Using "Unicompartmental knee arthroplasty kneeosteoarthritistitis application" as the English key word, "single condylar replacement," "knee joint, osteoarthritis" is the key word in Chinese. Results and conclusion: single condyle replacement of knee joint was performed only on the surface of unilateral lesion of knee joint in early stage of osteoarthritis of single compartment. The cartilage surface used to replace the destruction of tibiofemoral joint of knee joint has the advantages of less trauma, faster recovery, less complications, higher proprioceptive sensation and higher patient acceptance. The operative indication range is narrower than that of total knee arthroplasty, and the operation is limited. At the same time, the technique of total knee arthroplasty is more mature and the curative effect is certain. The single condyle replacement of knee joint is relatively late in China. The long-term clinical effect needs further clinical verification. However, if we can accurately grasp the indications of the operation, select the right patient, and carefully prepare for the operation, With the improvement of prosthesis and instrument design, the progress of surgical technique in the application of single condyle replacement in anterior medial compartment osteoarthritis of knee joint has a broad prospect.
【作者单位】：长治医学院附属和平医院骨科;
【基金】：山西省重点研发项目(201603D321064),项目名称:感染性疾病临床研究——利用基因修饰技术敲除超级细菌耐药基因治疗耐药菌骨感染~~
【分类号】：R687.4

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