探讨膝关节内侧间室骨关节炎行内侧单髁置换术对外侧间室退变的影响。

回顾分析2019年3月至2022年3月襄阳市第一人民医院骨科采用内侧活动平台单髁置换术（UKA）治疗膝关节内侧骨关节炎67例（69膝），其中男性14例（14膝），女性53例（55膝），年龄52至82岁，平均67岁，左膝病变35例，右膝病变30例，双膝病变2例，病史0.5~10年，测量患者术中假体安放的角度，比较患者术前、术后随访时牛津膝关节评分（OKS）、美国特种外科医院膝关节功能评分（HSS）、膝关节炎指数（WOMAC）变化，观察患者膝关节外侧是否有疼痛症状，膝关节正侧位片是否有外侧间室关节间隙变窄或消失，关节软骨下硬化，应用K-L分级标准进行分级。

所有患者均获得随访，随访时间6至36个月，末次随访时，患者HSS评分、OKS评分较术前明显升高，OWOMAC指数较术前明显下降，UKA股骨假体内翻位放置共10例，有7例患者随访时出现膝关节外侧疼痛症状，其中6例患者膝关节正侧位片出现外侧间室关节间隙变窄或消失，关节软骨下硬化改变。UKA股骨假体标准位置48例，有3例患者膝关节外侧疼痛症状，但复查膝关节正侧位片未见明显变化。UKA股骨假体外翻位放置共9例，有6例患者出现膝关节外侧疼痛症状，其中5例患者膝关节正侧位片出现外侧间室关节间隙变窄或消失，关节软骨下硬化改变。

内侧单髁置换术（UKA）治疗膝关节内侧间室骨关节炎近期临床效果显著，术中股骨假体放置不良会显著加速外侧间室退变。

To investigate the effect of medial unicompartmental knee arthroplasty (UKA) on lateral compartment degeneration in medial compartment osteoarthritis of the knee.

We retrospectively analyzed 67 patients (69 knees) with medial knee osteoarthritis treated with medial mobile bearing UKA at the Orthopedic Department of Xiangyang First People's Hospital from March 2019 to March 2022. There were 14 men (14 knees) and 53 women (55 knees), and they ranged in age from 52~82 years,with a mean age of 67 years. There were 35 cases with left knee lesions, 30 cases with right knee lesions, and 2 cases with bilateral knee lesions, with a medical history of 0.5 to 10 years. The patients' intraoperative prosthesis placement angles were measured, and changes in Oxford Knee Score (OKS), Hospital for Special Surgery Knee Function Score (HSS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) before operation and at postoperative follow-up were compared, and whether the patients had painful symptoms on the lateral side of the knee, narrowing or loss of the lateral compartment joint space, and subchondral sclerosis on the frontal and lateral views of the knee was recorded. The Kellgren-Lawrance grading criteria were applied for osteoarthritis grading.

All patients were followed up for 6-36 months. At the last follow-up, the patients' HSS score and OKS score were significantly higher than those before surgery, and the OWOMAC index was significantly lower than that before surgery. In ten cases, UKA femoral prosthesis was placed in the internal reversal position, and seven patients had lateral knee pain symptoms at the follow-up, among which six showed narrowing or loss of the lateral compartment joint space on the lateral knee radiographs and subchondral sclerosis changes. UKA femoral prosthesis was placed in the standard position in 48 cases, three patients had painful symptoms in the lateral knee, but no significant changes were seen in the lateral radiographs of the knee on review. In five of these patients, the lateral radiographs of the knee showed narrowing or loss of the lateral compartment space and subchondral sclerosis.

UKA for medial compartment osteoarthritis of the knee is clinically effective in the short term, and poor intraoperative femoral prosthesis placement accelerates lateral compartment degeneration.