摘要
[目的]探讨肥胖对非骨水泥活动平台UKA术后疗效的影响。[方法]本研究回顾性分析2023年3月—2024年3月在山西华晋骨科医院行膝关节内侧非水泥活动平台UKA的97例患者的临床资料。依据WHO的分类标准,将患者分为3组,其中,正常体重组14例,超重组42例,肥胖组41例。比较3组间的围手术期、随访和影像学资料。[结果]3组患者均顺利完成手术,无严重并发症。3组在手术时间、切口总长度、术中失血量、下地行走时间及住院时间等方面差异均无统计学意义(P>0.05)。随访时间8~12个月,3组患者均未发生假体松动、关节感染、垫片脱位等并发症。3组恢复完全负重活动时间的差异无统计学意义[d,(21.1±5.3)vs(23.1±5.0)vs(23.4±3.9),P=0.262]。随术前、术后3个月和末次随访的时间推移,3组的VAS评分均显著减少(P<0.05),而KSS功能评分、KSS临床评分、OKS评分均显著增加(P<0.05),最大伸膝ROM和最大屈膝ROM均显著改善(P<0.05)。相应时间点,3组间上述指标的差异均无统计学意义(P>0.05)。影像方面,与术前相比,末次随访时3组HKA、MPTA和PTS均显著改善(P<0.05)。相应时间点3组间HKA、MPTA和PTS的差异均无统计学意义(P>0.05)。[结论]肥胖不应成为单髁手术的禁忌,肥胖不影响非骨水泥活动平台单髁置换的临床效果。
[Objective]To explore the influence of obesity on the clinical consequence of cementless mobile-bearing Oxford unicom⁃partmental knee arthroplasty(UKA).[Methods]A retrospective study was conducted on 97 patients who underwent cementless mobile-bearing UKA for medial knee osteoarthritis in Shanxi Huajin Orthopedic Hospital from March 2023 to March 2024.According to the classi⁃fication criteria of the WHO,the patients were divided into three groups.Among them,14 patients were fall in the normal weight group,42 in the overweight group,and 41 in the obese group.The perioperative,follow-up and imaging data were compared among the three groups.[Results]All patients in the 3 groups had UKA performed successfully without serious complications.There were no significant differences among the 3 groups in terms of operation time,total incision length,intraoperative blood loss,postoperative ambulation time and hospital stay(P>0.05).The follow-up period ranged from 8 to 12 months,and no complications,such as prosthesis loosening,joint infection,or in⁃sert dislocation occurred in anyone of the 3 groups.There was no statistically significant difference in the time to resume full weight-bear⁃ing activities among the three groups[d,(21.1±5.3)vs(23.1±5.0)vs(23.4±3.9),P=0.262].Over time preoperatively,3 months after the oper⁃ation and the last follow-up,the VAS score was decreased significantly(P>0.05),while the KSS functional score,KSS clinical score and OKS score were increased significantly(P<0.05),and the maximum knee extension ROM and the maximum knee flexion ROM were im⁃proved significantly in all the 3 groups(P<0.05),whereas which proved not statistically different among the 3 groups at any time points ac⁃cordingly(P>0.05).As for imaging,compared with those before operation,the HKA,MPTA and PTS in all 3 groups were significantly im⁃proved at the last follow-up(P<0.05).However,there were no statistically significant differences in HKA,MPTA and PTS among the 3 groups at the corresponding time points(P>0.05).[Conclusion]Obesity should not be a contraindication for UKA.Obesity does not affect the clinical outcome of the cementless mobile-bearing UKA.
作者
张凯
王天翀
文云鹏
纪斌平
郭媛
杨雨竹
ZHANG Kai;WANG Tian-chong;WEN Yun-peng;JI Bin-ping;GUO Yuan;YANG Yu-zhu(Shanxi Huajin Orthopedics Research In-stitute,Shanxi Huajin Orthopedic Hospital,Taiyuan 030024,Shanxi,China;School of Biomedical Engineering,Taiyuan University of Technology,Jinzhong 030600,Shanxi,China)
出处
《中国矫形外科杂志》
北大核心
2026年第4期305-311,共7页
Orthopedic Journal of China
基金
国家自然科学基金项目(编号:11772214)。
关键词
肥胖
膝骨关节炎
单髁置换术
非骨水泥假体
活动平台假体
obesity
knee osteoarthritis
unicompartmental knee arthroplasty
non-cemented prosthesis
mobile-bearing prosthesis
