首页 > 过刊浏览>2025年第33卷第1期 >32-37. DOI:10.20184/j.cnki.Issn1005-8478.110290
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内侧室膝骨关节炎活动与固定平台单髁置换比较
作者:
作者单位:

1.徐州医科大学附属医院骨科，江苏徐州 221000 ;2.苏州大学附属第二医院骨科，江苏苏州 215004

作者简介:

王海波，主治医师，研究方向：骨与关节损伤，（电子信箱）JSXZW1989@163.com

中图分类号:

R684.3


Movable bearing versus fixed bearing prostheses in unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee
Author:
Affiliation:

.1.Department of Orthopedics,Affiliated Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221000 , China ;2.Department of Orthopaedics, The Second Affiliated Hospi⁃tal, Soochow University, Suzhou, Jiangsu 215004 , China

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    摘要:

    [目的] 探讨活动平台（mobile bearing, MB） 和固定平台（fixed bearing, FB） 行膝关节单髁置换术（unicompartmen-tal knee arthroplasty, UKA） 治疗内侧室膝关节骨关节炎（knee osteoarthritis, KOA） 的临床疗效。[方法] 回顾性分析本院2020年1 月—2023 年1 月行UKA 治疗的102 例的内侧室KOA 患者的临床资料。根据术前医患沟通结果，54 例采用MB 假体，48例采用FB 假体。对比两组围手术期、随访及影像指标。[结果] 所有患者均顺利完成手术，两组手术时间、切口长度、术中失血量、术后引流量、下地行走时间与住院时间的比较差异均无统计学意义（P＞0.05）。但MB 组治疗费用显著少于FB 组[(5.1±0.2)万元vs (5.5±0.3) 万元, P＜0.001]。随访时间平均（26.5±3.0） 个月。两组完全负重活动时间的差异无统计学意义（P＞0.05）。术后随时间推移，两组VAS 评分、WOMAC 评分、HSS 评分与膝伸屈ROM 均显著改善（P＜0.05）。相应时间点，两组间上述指标的差异均无统计学意义（P＞0.05）。与术前相比，末次随访两组股胫角（femorotibial angle, FTA）、髋-膝-踝角（hip-knee-ankle, HKA）、内侧胫骨近端角（medial proximal tibial angle, MPTA） 均显著改善（P＜0.05）；胫骨平台后倾角（posterior tibial slope, PTS） 无显著变化（P＞0.05），相应时间点，两组间上述影像指标的差异均无统计学意义（P＞0.05）。[结论] MB 与FB 行UKA 治疗内侧室KOA 疗效相当。

    Abstract:

    [Objective] To compared the clinical outcome of mobile bearing (MB) and fixed bearing (FB) platforms in unicompartmentalknee arthroplasty (UKA) in the treatment of medial compartment osteoarthritis of the knee. [Methods] A retrospective study was conductedon 102 patients who received UKA for medial compartment osteoarthritis of the knee in our hospital from January 2020 to January 2023. Ac-cording to preoperative doctor-patient communication, 54 patients received MB prosthesis and 48 patients received FB prosthesis. The peri-operative period, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had UKA performed suc-cessfully with no significant differences in operation time, incision length, intraoperative blood loss, postoperative drainage volume, walkingtime and hospital stay between the two groups (P＞0.05). However, the treatment cost in MB group was significantly lower than that in FBgroup [(5.1±0.2) 10k yuan vs (5.5±0.3) 10k yuan, P＜0.001]. The mean follow-up time was of (26.5±3.0) months, and there was no significantdifference in the time to regain full weight-bearing activities between the two groups (P＞0.05). The VAS score, WOMAC score, HSS scoreand extension-flexion range of motion (ROM) were significantly improved in both groups over time postoperatively (P＜0.05), whereas whichwere not statistically significant between the two groups at any corresponding time points (P＞0.05). As for imaging, femorotibial angle (FTA),hip-knee-ankle (HKA) and medial proximal tibial angle (MPTA) were significantly improved in both groups at the latest follow-up com-pared with those preoperatively (P＜0.05), whereas there were no significant changes in posterior tibial slope (PTS) (P＞0.05). At any timepoints accordingly, there were no significant differences in the above image indicators between the two groups (P＞0.05). [Conclusion] TheMB UKA and FB UKA achieve comparable clinical consequences for medial compartment osteoarthritis of the knee.

    参考文献
    [1] LiewJW,KingLK,MahmoudianA,etal.Ascopingreviewofhowear?ly-stagekneeosteoarthritishas been defined [J].Osteoarthritis Cartilage,2023,31(9):1234-1241.DOI:10.1016/j.joca.2023.04.015.
    [2] 袁札根,卿勇,孙淑梅,等.膝内侧室骨性关节炎单髁置换60岁上下比较[J].中国矫形外科杂志,2023,31(13):1158-1163.DOI:10.3977/j.issn.1005-8478.2023.13.02.Yuan ZG,Qing Y,Sun SM,et al.Comparison of unicompartmental knee arthroplasty for anteromedial osteoarthritis between patientsolder and younger than 60 years old [J].Orthopedic Journal of China,2023,31(13):1158-1163.DOI:10.3977/j.issn.1005-8478.2023.13.02.
    [3] 包杭生,冯宗权,邹勇根.三种术式治疗膝骨关节炎的凝血与临床比较[J].中国矫形外科杂志,2023,31(1):15-20.DOI:10.3977/j.issn.1005-8478.2023.01.03.Bao HS,Feng ZQ,Zou YG.Effect of three surgical procedures forknee osteoarthritis on coagulation and clinical outcomes [J].Orthopedic Journal of China,2023,31(1):15-20.DOI:10.3977/j.issn.1005-8478.2023.01.03.
    [4] 薛华明,马童,文涛,等.再议膝关节单髁置换术的适应证[J].中华医学杂志,2024,104(5):319-324.DOI:10.3760/cma.j.cn112137-20230518-00820.Xue HM,Ma T,Wen T,et al.Reconsideration of the indications forunicompartmental knee arthroplasty [J].National Medical Journal of China,2024,104(5):319-324.DOI:10.3760/cma.j.cn112137-20230518-00820.
    [5] Crawford DA,Berend KR,Thienpont E.Unicompartmentalkneear?throplasty:US and global perspectives [J].Orthop Clin North Am,2020,51(2):147-159.DOI:10.1016/j.ocl.2019.11.010.
    [6] 马尚,王上增.单室膝骨关节炎单髁与全膝置换术短期效果比较[J].中国矫形外科杂志,2021,29(15):1359-1363.DOI:10.3 977/j.issn.1005-8478.2021.15.04.Ma S,Wang SZ.Comparison of short-term outcomes of unicompart?mental knee arthroplasty versus total knee arthroplasty for medialunicompartmental knee osteoarthritis [J].Orthopedic Journal ofChina,2021,29(15):1359-1363.DOI:10.3977/j.issn.1005-8478.2021.15.04.
    [7] 张仁卓,荆琳,潘丽,等.固定平台假体与活动平台假体在膝关节单髁置换术中应用的效果比较[J].山东医药,2021,61(13):84-86.DOI:10.3969/j.issn.1002-266X.2021.13.024.Zhang RZ,Jing L,Pan L,et al.Comparison of the effect of fixedplatform prosthesis and movable platform prosthesis in unicondylarknee replacement [J].Shandong Medical Journal,2021,61(13):84-86.DOI:10.3969/j.issn.1002-266X.2021.13.024.
    [8] 姜灵凯,魏垒,董政权,等.活动平台与固定平台单髁置换治疗内侧膝骨关节炎的Meta分析[J].中国骨伤,2022,35(1):67-75.DOI:10.12200/j.issn.1003-0034.2022.01.014.Jiang LK,Wei L,Dong ZQ,et al.META analysis of mobile bearingand fixed bearing unicondyle replacement for medial knee osteoarthritis [J].China Journal of Orthopaedics and Traumatology,2022,35(1):67-75.DOI:10.12200/j.issn.1003-0034.2022.01.014.
    [9] Kellgren JH,Lawrence JS.Radiological assessment of osteo-arthrosis [J].Ann Rheum Dis,1957,16(4):494-502.DOI:10.1136/ard.16.4.494.
    [10] Faiz KW.VAS-visualanalogscale [J].Tidsskr Nor Laegeforen,2014,134(3):323.DOI:10.4045/tidsskr.13.1145.
    [11] 严攀,刘波,阴俊,等.西安大略和麦克马斯特大学骨关节炎指数用于膝退行性骨关节炎患者评定的反应度研究[J].中国康复医学杂志,2016,31(2):215-216.DOI:10.3969/j.issn.1001-1242.2016.02.019.Yan P,Liu B,Yin J,et al.A reactivity study of the Western Ontario and McMaster University Osteoarthritis Index used to assess patients with degenerative osteoarthritis of the knee [J].Chinese Journal of Rehabilitation Medicine,2016,31(2):215-216.DOI:10.3969/j.issn.1001-1242.2016.02.019.
    [12] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:169-178.Jiang XY,Wang DW.Orthopaedic clinical efficacy evaluation criteria[M].Beijing:People'sMedicalPublishingHouse,2005:169-178.
    [13] 杨宇锋,李政甜,杜刚.单髁膝关节置换术后运动影像力学分析[J].中国矫形外科杂志,2022,30(12):1134-1136.DOI:10.3977/j.issn.1005-8478.2022.12.17.Yang YF,Li ZT,Du G.An analysis on radiographic kinematics ofunicompartmental knee arthroplasty [J].Orthopedic Journal of China,2022,30(12):1134-1136.DOI:10.3977/j.issn.1005-8478.2022.12.17.
    [14] Bonano JC,Barrett AA,Amanatullah DF.Medialunicompartmental?kneearthroplastywith amobile-bearingimplant [J].JBJS Essent SurgTech,2021,11(2):e20.00002.DOI:10.2106/JBJS.ST.20.00002.
    [15] Ma P,Muheremu A,Zhang S,et al.Biomechanical effects of fixedbearingfemoralprostheseswithdifferentcoronal positions in medial?unicompartmentalkneearthroplasty [J].J Orthop Surg Res,2022,17(1):150.DOI:10.1186/s13018-022-03037-0.
    [16] 刘少华,周观明,陈希聪,等.活动与固定平台单髁置换治疗膝关节内侧单间室骨关节炎的随访[J].中国组织工程研究,2020,24(36):5785-5792.DOI:10.3969/j.issn.2095-4344.2930.Liu SH,Zhou GM,Chen XC,et al.Mobile bearing and fixed bearing unicompartmental knee arthroplasty for medial knee osteoarthritis [J].Chinese Journal of Tissue Engineering Research,2020,24(36):5785-5792.DOI:10.3969/j.issn.2095-4344.2930.
    [17] 马锐祥,李乾明,张贤祚,等.活动平台与固定平台单髁置换治疗膝内侧单间室骨关节炎的短期疗效及成本对比[J].安徽医学,2021,42(9):1043-1046.DOI:10.3969/j.issn.1000-0399.2021.09.022.Ma RX,Li QM,Zhang XZ,et al.Short-term efficacy and cost comparison of movable and fixed bearing monondylar replacement inthe treatment of single compartment osteoarthritis of medial knee[J].Anhui Medical Journal,2021,42(9):1043-1046.DOI:10.3969/j.issn.1000-0399.2021.09.022.
    [18] 薛军,蒋毅,任忠明,等.活动与固定平台在单髁膝关节置换术治疗膝内侧间室骨关节炎中的疗效比较[J].临床骨科杂志,2022,25(4):497-501.DOI:10.3969/j.issn.1008-0287.2022.04.016.Xue J,Jiang Y,Ren ZM,et al.Comparison effect of mobile-bearing and fixed-bearing unicompartmental knee arthroplasty for medial compartment osteoarthris of the knee [J].Journal of ClinicalOrthopaedics,2022,25(4):497-501.DOI:10.3969/j.issn.1008-0287.2022.04.016.
    [19] 雷雪枫,张文正,薛华明,等.活动平台单髁假体和固定平台单髁假体治疗膝关节内侧间室骨性关节炎的研究进展[J].生物骨科材料与临床研究,2023,20(1):76-79.DOI:10.3969/j.issn.1672-5972.2023.01.015.Lei XF,Zhang WZ,Xue HM,et al.Research progress of mobilebearing monocondylar prosthesis and fixed bearing monocondylarprosthesis in the treatment of medial compartmental knee osteoarthritis [J].Orthopaedic Biomechanics Materials and ClinicalStudy,2023,20(1):76-79.DOI:10.3969/j.issn.1672-5972.2023.01.015.
    [20] Migliorini F,Maffulli N,Cuozzo F,et al.Mobile bearing versusfixed bearing for unicompartmental arthroplasty in monocompart?mental osteoarthritis of the knee:a meta-analysis [J].J Clin Med,2022,11(10):2837.DOI:10.3390/jcm11102837.
    [21] Peersman G,Stuyts B,Vandenlangenbergh T,et al.Fixed-versusmobilebearing UKA:A systematic review and meta-analysis [J].Knee Surg Sports Traumatol Arthrosc,2015,23(11):3296-3305.DOI:10.1007/s00167-014-3131-1.
    [22] Pronk Y,Paters AAM,Brinkman JM.No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmen?tal knee arthroplasty [J].Knee Surg Sports Traumatol Arthrosc,2021,29(3):947-954.DOI:10.1007/s00167-020-06053-x.
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引用本文

王海波,冯骁,王龙,等. 内侧室膝骨关节炎活动与固定平台单髁置换比较[J]. 中国矫形外科杂志, 2025, 33 (1): 32-37. DOI：10.20184/j. cnki. Issn1005-8478.110290.
WANG Hai-bo, FENG Xiao, WANG Long, et al. Movable bearing versus fixed bearing prostheses in unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee[J]. Orthopedic Journal of China , 2025, 33 (1): 32-37. DOI：10.20184/j. cnki. Issn1005-8478.110290.

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  • 收稿日期:2024-04-15
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