通过分析牛津3期活动平台人工单髁关节置换假体生存率，探讨其中长期临床疗效以及相关并发症的处理原则和预防策略。

选择自2007年4月至2016年10月期间，济南军区总医院骨病科应用人工单髁关节置换手术患者共435例515膝，均系膝关节前内侧骨关节病，其中男150例，女285例；年龄45～83岁，平均(61±8)岁。身体质量指数19～36 kg/m^2,平均(24±3)kg/m²。记录手术前后膝关节活动度(ROM)变化，采用美国膝关节协会评分(KSS评分)与牛津大学膝关节评分(OKS评分)评估临床疗效，记录术后所有并发症发生情况；采用Kaplan-Meier生存分析方法评估患者的假体生存率，对术前及末次随访的ROM变化、KSS评分、OKS评分分别进行配对t检验，以P<0.05为差异有统计学意义。

435例515膝全部完成随访，平均(5.2±1.8)年。至末次随访时，KSS评分由术前平均(59±10)，改善至术后平均(93±8)(t＝－2.586，P<0.05)；OKS评分由术前平均(24±8)，提高至术后平均(43±5)(t ＝－2.056，P <0.05)；膝关节术前平均(111±5)°，术后ROM平均(127±8)°(t ＝－2.334，P <0.05)。所有患者人工单髁关节假体总生存率为92.2%。515膝单髁关节中共有15例(2.9%)并发症发生，其中聚乙烯活动半月板衬垫脱位6例(1.2%)；迟发性深部感染1例(0.2%)，经规范抗感染治疗无效后行二期全膝关节翻修术，术后正常恢复；3例出现股骨髁侧假体松动(0.6%，含1例同时衬垫脱位病例)，其中2例进行单髁关节翻修，1例予以全膝关节翻修；2例患者出现关节囊反复无菌性积液(0.4%)，予以关节抽液并物理治疗后恢复；2例术后出现关节内游离体(0.4%)，行关节镜手术取出后绞索症状消失；1例术后膝关节不明原因疼痛(0.2%)，保守治疗后恢复；1例术中前交叉韧带止点部分撕脱(0.2%)，术中予以韧带线缝合固定，术后铰链支具固定41周后功能锻炼，膝关节功能恢复良好。

牛津3期活动平台人工单髁关节置换是治疗膝内侧骨关节病的最佳治疗方法，临床疗效可靠，相关并发症发生率低；正确的适应证选择及成熟的外科操作能够保证UKA获得良好效果，降低并发症发生率；并发症的治疗需仔细分析发生的原因和类型，给予适当的处理。

To analyze the long-term survival rate of Oxford medial unicompartmental knee arthroplasty, and to investigate the management and prevention strategy for complications.

A retrospective analysis was performed on 435 patients (515 knees) with anteromedial osteoarthritis of knee treated by Oxford unicompartmental knee arthroplasty in the Department of Orthopedic, the General Hospital of Jinan Military Commanding Region, from April 2007 to October 2016. There were 150 males and 285 females, whose mean age was (61±8) years. The mean body mass index (BMI) was (24±3) kg/m², range: 19~36 kg/m². The knee range of movement (ROM), Knee Society score (KSS) and Oxford knee score (OKS) were used to evaluate the clinical efficacy. All the postoperative complications were recorded, and Kaplan-Meier survival analysis was used to evaluate the survival rate of the prosthesis. The ROM, KSS score and OKS score were analysized by paired t test.

The average follow-up time was (5.2±1.8) years. The preoperative KSS score was (59±10), and the postoperative KSS score was (93±8)(t=-2.586, P<0.05). The preoperative OKS score was (24±8), and the postoperative OKS score was (43±5)(t=-2.056, P <0.05). The preoperative ROM of knee was (111±5) °, and the postoperative ROM of knee was (127±8) °(t=-2.334, P <0.05). The total survival rate of the prosthesis was 92.2%.There were 15 cases with complications(2.9%): six cases of polyethylene insert dislocation (1.2%); one case of delayed deep infections (0.2%), treated with revision of total knee arthroplasty; three cases of femoral condyle prosthesis loosening (0.6%), including one case of dislocation at the same time, of which two cases were treated with revision of unicompartmental arthroplasty and one case was treated with revision of total knee arthroplasty; two cases of recurrent aseptic joint effusion (0.4%), treated with joint drainage and physiotherapy; two cases of intra-articular free bodies(0.4%), treated with arthroscopic surgery; one case of unexplained pain, recovered after conservative treatment; one case of intraoperative injury of anterior cruciate ligament (0.2%), treated with ligament suture during operation and the hinge brace was fixed for four weeks, and the function of the knee joint recovered.

Oxford medial unicompartmental knee arthroplasty is the best treatment for antero-medial osteoarthritis of knee, of which the clinical efficacy is reliable, and the incidence of complications is low. Mature surgical procedures can ensure good results of UKA and reduce the incidence of complications. The causes and types of complications should be carefully analyzed and appropriate treatment should be given.