【Abstract】 Objective To evaluate the mid-term effectiveness of Oxford Unicompartmental Knee system Phase III for medial unicompartmental knee osteoarthritis (OA). Methods Between December 2008 and August 2010, 26 patients (32 knees) with medial unicompartmental knee OA were treated. Of 26 patients, 11 were followed up more than 2 years, including 7 males and 4 females (14 knees, 6 left and 8 right knees) with an average age of 62.4 years (range, 50-74 years). All patients had load suffering and tenderness of medial unicompartmental knee, and complicated by varus deformity without limitation of flexion and extension; the disease duration ranged 5-23 years (mean, 11.6 years). According to Ahlback staging, 4 knees were at stage II and 10 knees at stage III. Cemented unicompartmental knee arthroplasty (Oxford Unicompartmental Knee system Phase III) was performed by minimally invasive technique. Results All the incisions were primary healing after operation. Five cases suffered from local ache in the pes anserinus during the first 3 months after operation, which was cured after conservative therapy. Of them, 11 patients were followed up 27.5 months on average (range, 24-30 months). During follow-up, no complication of prosthesis loosening, displacement, arthropathy in the opposite department, or the patellofemoral joint occurred. The range of motion was significantly improved from (109.2 ± 8.7)° preoperatively to (123.5 ± 6.7)° at last follow-up (P lt; 0.05); knee society score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores were all significantly improved (P lt; 0.05). At last follow-up, the femoro-tibial angle was significantly improved (P lt; 0.05); tibial plateau and the tibial anatomical axis increased, showing no significant difference (P gt; 0.05); and posterior tibial slope was significantly decreased (P lt; 0.05). Conclusion Oxford Unicompartmental Knee system Phase III has satisfactory mid-term effectiveness in treating medial unicompartmental knee OA with the advantages of little trauma and rapid recovery, but long-term effectiveness is expected for further follow-up.
Objective To evaluate an improving operative procedure and the cl inical results of arthroscopically assisted treatment for acute patellar dislocation. Methods Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, release of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The disease duration was 1-10 days with an average of 5.9 days. All patients had lateral dislocation; of them, 14 patients showed reduction without treatment, and 8 patients showed dislocation at admission and were given close manipulative reduction. The results were positive for apprehension test in all patients with the l imitation of passive motion and for Ballottable Patella Sign in 15 cases. Lysholm score, visual analogue scale (VAS) score, and Insall scale were adopted to evaluate the effect. Results All incisions healed by first intention. All the patients were followed up 12-36 months (17 months on average). During the first 3 months after operation, sunken skin in the puncture point medial to the patella was observed in 12 knees; 10 knees suffered pain of the soft tissue lateral to the patella; 15 knees felt tense in the soft tissue medial to the patella, however, all these problems disappeared or recovered gradually after rehabil itation and conservative treatment. No recurrence of dislocation was observed during the follow-up. Lysholm score was significantly improved from preoperative 67.3 ± 5.7 to postoperative 96.6 ± 4.5 (t=3.241, P=0.003) and VAS score from 6.5 ± 0.5 to 1.8 ± 0.4 (t=2.154, P=0.040). According to Insall scale, the results were excellent in 18 knees, good in 5 knees, and fair in 2 knees at 1 year after operation with an excellent and good rate of 92%. Conclusion The improving procedure of arthroscopically assisted treatment for acute patellar dislocation is a minimally invasive operation and has a number of benefits. Its short-term cl inical outcome was satisfactory.