Objective: To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee.
Methods: The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m 2 (range, 19.8-35.6 kg/m 2). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb.
Results: The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision.
Conclusion: For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.
目的: 探讨人工单髁置换术（unicompartmental knee arthroplasty，UKA）治疗膝关节创伤性关节炎（post-traumatic arthritis，PTA）的早中期疗效。.
方法: 回顾性分析2014年3月—2021年9月采用UKA治疗的30例（30膝）膝关节PTA患者临床资料。男14例，女16例；年龄33～81岁，平均64.5岁。身体质量指数19.8～35.6 kg/m 2，平均26.7 kg/m 2。引起PTA的损伤类型：关节内骨折16例，关节外骨折8例，软组织损伤6例。损伤治疗方式：保守治疗12例，手术治疗18例。PTA累及内侧间室10例，外侧间室20例。Kellgren-Lawrence分级：Ⅲ级19例，Ⅳ级11例。记录手术时间、住院时间、并发症发生情况以及患者自评满意度。采用牛津膝关节评分（OKS）、美国特种外科医院（HSS）评分以及膝关节活动度（range of motion，ROM）评价膝关节功能。摄负重位X线片测量股胫角，评估下肢力线矫正情况。.
结果: 手术时间50～95 min，平均63.7 min；住院时间3～8 d，平均6.9 d。 2例发生切口浅表感染，其余患者切口均Ⅰ期愈合；均无下肢深静脉血栓形成、血管神经损伤等并发症发生。患者均获随访，随访时间17～109个月，中位时间70个月。末次随访时，患者OKS评分、HSS评分和ROM均较术前改善（ P<0.05）；下肢力线获得矫正，内、外翻膝股胫角手术前后比较差异均有统计学意义（ P<0.05）。患者手术满意率达86.7%（26/30）。随访期间2例外侧间室UKA患者发生对侧间室进展性关节炎。影像学复查示均无垫片脱位、假体松动及假体下沉发生，无1例行假体翻修。.
结论: 采用UKA治疗膝关节PTA早中期疗效确切，患者满意度高。.
Keywords: Post-traumatic arthritis; knee; short- and mid-term effectiveness; unicompartmental knee arthroplasty.