摘要目的:探讨外侧髌股关节退变对膝关节内侧牛津活动平台单髁置换术（OUKA）治疗膝关节前内侧骨关节炎效果的影响。方法:回顾性分析2016年3月至2017年12月首都医科大学宣武医院骨科采用OUKA治疗的73例膝关节前内侧骨关节炎患者的临床资料。男性18例，女性55例，年龄（68.6±7.5）岁（范围：53~89岁）。根据Ahlback分级系统对患者外侧髌股关节情况进行评估，Ahlback 0、Ⅰ级患者为未退变组（37例），Ⅱ级及以上患者为退变组（36例）。记录患者手术前后美国特种外科医院膝关节评分（HSS）和西安大略和麦克马斯特大学（WOMAC）骨关节炎指数，以及蹲起、坐起和上下楼等动作完成情况。手术前后数据比较采用配对样本 t检验，组间比较采用独立样本 t检验。计数资料的比较采用χ 2检验。Ahlback评分和HSS差值、WOMAC骨关节炎指数差值相关性研究采用Pearson相关性分析。 结果:所有患者均获得随访，随访时间（35.1±6.6）个月（范围：25~47个月）。HSS由术前的（57.7±11.8）分升至末次随访时的（81.8±7.8）分（ t=-16.64， P=0.00），WOMAC骨关节炎指数由术前的（48.9±13.4）分降至（15.6±8.8）分（ t=20.48， P=0.00）。退变组与未退变组手术前后HSS差值的差异无统计学意义[（27.5±12.2）分比（22.5±12.3）分， t=-1.65， P=0.10]；WOMAC骨关节炎指数差值的差异亦无统计学意义[（31.8±14.0）分比（36.4±13.4）分， t=-1.35， P=0.18]，但外侧髌股关节退变与无法完成蹲起（χ 2=5.17， P=0.04)、坐起（χ 2=7.22， P=0.01）等动作相关。 结论:外侧髌股关节退变并未影响膝关节前内侧骨关节炎患者膝关节内侧OUKA术后的早期功能恢复。

abstractsObjective:To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty.Methods:The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively.There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years).The lateral patellofemoral joints of patients were evaluated by Ahlback grading system. Patients with Ahlback 0 andⅠ were in the non degenerative group (37 cases), and those with Ahlback Ⅱ and above were in the degenerative group (36 cases). Hospital for special surgery knee score(HSS) and the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index, as well as the condition of kneeling, sit to stand movement, up stair and down stair were recorded. The data before and after operation were compared by paired sample t test, and the data between groups were compared by independent sample t test. χ 2 test was used for counting data. Pearson correlation analysis was used to compare the correlation between ahlback score, HSS and WOMAC osteoarthritis index. Results:The follow-up time was (35.1±6.6) months (range: 25 to 47 months).The knee function of the patients improved significantly after operation.The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative ( t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative ( t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ 2=5.17, P=0.04) and sitting up (χ 2=7.22, P=0.01). Conclusion:The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.