| 固定平台单髁翻修治疗活动平台单髁衬垫脱位的临床结局和患者满意度 |
| Clinical outcomes and patient satisfaction of fixed-bearing unicompartmental knee arthroplasty revision for dislocation of mobile-bearing unicompartmental knee arthroplasty liner |
| 投稿时间：2025-12-15 |
| DOI：10.3969/j.issn.1672-5972.2026.04.005 |
| 中文关键词: 膝关节骨关节炎 单髁关节置换术 活动平台 固定平台 翻修 |
| 英文关键词:Knee osteoarthritis Unicompartmental knee arthroplasty Mobile-bearing Fixed-bearing Revision |
| 基金项目:南京医科大学科技发展基金项目（NMUB20250075） |
| 作者 | 单位 | 邮编 | | 唐儒龙* | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 周晓强 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 李志强 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 刘宇博 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 徐人杰 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 佘远时 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 胥正泉 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 张向鑫 | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 | | 虞宵* | 南京医科大学附属苏州医院（苏州市立医院）骨科与运动医学中心,江苏 苏州,215000 | 215000 |
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| 中文摘要: |
| 目的 评价接受固定平台单髁（fixed-bearing unicompartmental knee arthroplasty, FB-UKA）翻修治疗活动平台单髁置换（mobile-bearing unicompartmental knee arthroplasty, MB-UKA）衬垫脱位后的临床结局和患者满意度，并与接受初次固定平台单髁置换术的患者进行比较。方法 回顾性分析2017年6月至2023年12月于苏州市立医院骨科与运动医学中心收治的因MB-UKA术后衬垫脱位接受FB-UKA翻修手术治疗的12例患者临床资料，纳入翻修组。并采用倾向性评分匹配按照1∶2比例在性别、年龄、身高体重指数（body mass index, BMI）、Charlson年龄-合并症指数（age-adjusted Charlson comorbidity index, ACCI）与同期因膝关节内侧间室骨关节炎接受初次FB-UKA手术治疗的24例患者配对，纳入初次组。比较两组患者的手术时间、围手术期总失血量、术后住院时间、术后早期并发症；术后患者报告结局指标（patient reported outcome measures, PROMs）包括疼痛视觉模拟评分（visual analogue scale, VAS）、膝关节活动度（range of motion, ROM）、膝关节协会评分（knee society score, KSS）、Oxford膝关节评分（Oxford knee score, OKS）、SF-36评分（short form-36 health survey）及患者的手术预期和整体满意度。结果 所有患者均完成随访，平均随访时间为（26.45±2.32）个月（24～36个月）。相比于初次组，翻修组患者的手术时间、围手术期总失血量及术后住院时间均更多（P＜0.05）；术后1、3周，翻修组的VAS评分高于初次组，而膝关节ROM低于初次组，差异均有统计学意义（P＜0.05）；两组术后1、3个月的VAS评分和膝关节ROM比较，差异无统计学意义（P＞0.05）；术后早期并发症及随访期间假体相关并发症比较，差异无统计学意义（P＞0.05）；随访2年期间，两组的术后PROMs和患者满意度比较，差异无统计学意义（P＞0.05）。结论 采用FB-UKA翻修治疗MB-UKA衬垫脱位的术后患者报告结局指标较术前显著改善，且MB-UKA衬垫脱位翻修至FB-UKA和初次FB-UKA术后的临床结局和患者满意度相似。 |
| 英文摘要: |
| Objective To evaluate the clinical outcomes and patient satisfaction of patients who underwent revision surgery with fixed-bearing unicompartmental knee arthroplasty (FB-UKA) for mobile-bearing unicompartmental knee arthroplasty (MB-UKA) liner dislocation, and to compare these outcomes with those of patients who received primary FB-UKA.Methods A retrospective analysis was performed on the clinical data of 12 patients who underwent revision surgery with FB-UKA for liner dislocation after MB-UKA at the department of Orthopedics, Suzhou Municipal Hospital, from June 2017 to December 2023, and these patients were enrolled as the revision group. A 1:2 propensity score matching was conducted to pair these patients with 24 contemporaneous patients who received primary FB-UKA for medial compartment knee osteoarthritis, with matching criteria including gender, age, body mass index (BMI), age-adjusted Charlson comorbidity index (ACCI). These 24 patients were enrolled as the primary group. The two groups were compared in terms of operative time, total perioperative blood loss, postoperative length of hospital stay, and early postoperative complications. Additionally, comparisons were made regarding postoperative patient-reported outcome measures (PROMs), including the visual analogue scale (VAS) for pain, knee range of motion(ROM), Knee Society Score(KSS), Oxford Knee Score(OKS), Short Form 36 Health Survey(SF-36), as well as patients' surgical expectations and overall satisfaction.Results All patients completed follow-up, with a mean follow-up time of (26.45±2.32) months (24-36 months). Compared with the primary group, the revision group had significantly longer operative time, greater total perioperative blood loss, and longer postoperative length of hospital stay (P<0.05). At 1st and 3rd weeks postoperatively, the revision group had higher VAS scores and lower knee ROM than the primary group, with statistically significant differences (P<0.05). There were no statistically significant differences in VAS scores and knee ROM between the two groups at 1st and 3rd months postoperatively (P>0.05). No significant differences were observed in early postoperative complications and prosthesis-related complications during the follow-up period between the two groups (P>0.05). During the 2-year follow-up, there were no significant differences in postoperative PROMs and patient satisfaction between the two groups (P>0.05).Conclusion PROMs of patients undergoing revision surgery with FB-UKA for MB-UKA liner dislocation were significantly improved compared with those before surgery. Moreover, the clinical outcomes and patient satisfaction after revision from MB-UKA liner dislocation to FB-UKA were comparable to those after primary FB-UKA. |
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