中文摘要：

目的探讨应用关节镜检查评估单髁置换手术(UKA)指征的可行性和风险与收益评价。方法回顾性分析2012年1月至2014年3月,25例在杨浦医院关节外科拟行UKA治疗膝骨关节炎患者,因术前手术指征存疑的在术前行关节镜检查。观察检查准确性、手术时间和并发症,采用美国膝关节协会评分(KSS评分)对术后膝关节功能进行评估。结果 25例关节镜检查时间平均7.3min(5~10 min),关节镜检查后25例患者中7例(28%)更换手术方式。所有患者均获得了完整的随访,术后平均随访15个月(6~30个月),无感染、脂肪栓塞或下肢深静脉血栓形成,末次随访患者膝关节疼痛消失或明显减轻。术后KSS膝评分(92±7)分与术前(55±9)分比较有统计学差异(t=20.73,P<0.01);术后KSS功能评分(92±8)分与术前(56±7)分比较有统计学差异(t=34.40,P<0.01)。根据评分22例疗效优秀,3例良好,行关节置换患者在随访期内无假体磨损,松动,脱位和进展性骨关节炎等并发症。结论关节镜检查具有更高准确率,操作简单,且并不增加手术感染率和手术风险。在术前明确手术指征困难的患者中,关节镜检查相对术中直视下检查更具优势。

英文摘要：

Objective To evaluate the feasibility and risk-benefit of arthroscopy before unicompartmental knee arthroplasty (UKA).Methods Between January 2012 and December 2014, 25 patients who were doubted about the indications underwent arthroscopy before UKA in joint surgery department of Yangpu Hospital.The accuracy of the examination, surgical time and complications were observed and recorded.The pre-and post-operative functions of the knees were evaluated by American knee society score (KSS).Results The mean surgical time was 7.3 min (5 -10 min).Seven cases (28%) changed surgical option.All the cases were followed up for 15 months (6 -30 months) in average;none of them had complications of infection, fat embolism, deep vein thrombosis, malposition of prosthesis, dislocation or loosening.The postoperative KSS knee score ( 92 ±7 ) showed significant difference compared with the preoperative one (55 ±9) (t =20.73,P<0.01); the postoperative KSS function score ( 92 ±8 ) also showed significant difference compared with the preoperative one ( 56 ±7 ) (t=34.40,P<0.01).According to the KSS score, 22 cases were excellent, and three cases were good. At the last follow up, all the cases achieved significant relief of pain.Conclusion These results indicate that arthroscopy has excellent accuracy and will not increase the risks of infection or complication, which can be used in workup for the patients who are doubted about the indications before UKA.