单髁置换与全膝置换近期临床疗效对比  

Comparative study of clinical curative effect between unicompartment arthroplasty and total knee arthroplasty

作　　者：沈鹏[1] 周秉正[1] 白伦浩[1] 

机构地区：[1]中国医科大学附属盛京医院关节,运动医学病房,辽宁沈阳116400

出　　处：《中国医药导报》2015年第18期55-57,共3页China Medical Herald

基　　金：国家自然科学基金资助项目(81272050)

摘　　要：目的：探讨单髁置换术（UKA）与全膝关节置换术（TKA）治疗膝关节骨关节炎近期临床效果。方法将2014年3月~2015年1月中国医科大学附属盛京医院关节、运动医学病房收治膝关节内侧髁单间室骨关节炎患者共75例随机分为TKA组及UKA组,其中UKA组30例（32个膝）,TKA组45例（50个膝）。对两组患者手术前后美国特种外科医院（HSS）评分、手术时间、术中出血量及术后引流量进行比较。结果术后3个月[TKA组：（78.69±3.55）分,UKA组：（86.78±3.51）分,t=10.073,P〈0.01]、术后6个月[TKA组：（83.18±3.19）分,UKA组：（87.25±3.27）分,t=5.555,P〈0.01]、术后1年[TKA组：（84.92±2.75）分,UKA组：（87.66±3.03）分,t=4.023,P〈0.01]两组HSS评分比较,差异均有高度统计学意义。手术时间TKA组[（62.14±5.24）min]与UKA组比较[（63.84±4.39）分],差异无统计学意义（t=1.527,P＆gt;0.05）。术中出血量TKA组[（111.69±23.22）mL]与UKA组比较[（61.97±9.15）mL],差异有高度统计学意义（t=11.527,P〈0.01）,术后引流量为（291.71±48.49）mL,UKA组为（82.28±9.12）mL,差异有高度统计学意义（t=24.107,P〈0.01）。结论 UKA的近期疗效优于TKA,UKA具有创伤小、截骨量少、出血少、患者耐受性好、保留膝关节本体感觉、术后恢复快等优点。Objective To compare the short-term clinical curative effect of unicompartment knee arthroplasty （UKA） and total knee arthroplasty （TKA） for the treatment of osteoarthritis of knee joint. Methods From March 2014 to Jan-uary 2015, 75 patients with knee medial condyle unicompartmental osteoarthritis in Joint and Sports Medicine Ward, Shenjing Hopital of China Medical University were randomly assigned to TKA group and UKA group. There were 30 cases （32 knees） in the UKA group and 45 cases （50 knees） in the TKA group. The curative effect was evaluated by intraoper-ative hemorrhage, HSS score, operative time, and the volume of drainage. Results 3 months after operation, HSS score of TKA group was （78.69±3.55） scores, UKA group was （86.78±3.51） scores, （t=10.073, P〈0.01）;6 months after oper-ation, HSS score of the TKA group was （83.18±3.19） scores, UKA group was （87.25±3.27） scores, （t=5.555, P〈 0.01）;after 1 year the HSS score of the TKA group was （84.92±2.75） scores, UKA group was （87.66±3.03） scores, （t=4.023, P〈0.01）;the differences were statistically significant. Operation time of TKA group was （62.14±5.24） scores, and that of the UKA group was （63.84±4.39） scores, had no statistically significant difference （t=1.527, P＆gt;0.05）. The amount of bleed-ing of TKA group was （111.69±23.22） mL, and that of the UKA group was （61.97±9.15） mL, the difference was statisti-cally significant （t=11.527, P〈 0.01）, postoperative drainage of the TKA group was （291.71±48.49） mL, and that of the UKA group was （82.28±9.12） mL, the difference was statistically significant （t=24.107, P〈0.01）. Conclusion The uni-compartment knee arthroplasty treatment of osteoarthritis of knee joint is better than TKA in short term. This surgery technique has more minimally trauma,less bleeding and less bone resection. UKA can also obtain good function recov-ery, keep knee proprioception and promote patient tolerance.

关 键 词：单髁置换 全膝置换 近期疗效 对比研究 

分 类 号：R687.4[医药卫生—骨科学]