单髁与全膝关节置换术对伸膝肌力影响的差异  

Difference in influences on extensional strength of knee between unicompartmental and total knee arthroplasties

作　　者：李之琛[1] 陈东峰[1] 赵杰[2] 陈艺[1] 张姝江[1] 卢伟杰[1] Li Zhichen Chen Dongfeng Zhao Jie Chert Yi Zhang Shujiang Lu Weijie(Orthopedics Department, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China Guangdong Pharmaceutical University, Guangzhou 510224, China)

机构地区：[1]广州医科大学附属第一医院关节外科,510120 [2]广东药科大学健康学院,广州510224

出　　处：《中华关节外科杂志（电子版）》2017年第3期27-30,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的评价单髁膝关节置换术(UKA)与全膝关节置换术(TKA)对伸膝肌力影响的差异。方法分析2015年1月至2016年12月间因膝关节骨关节炎于广州医科大学附属第一医院关节外科施行的39例TKA与30例UKA,记录性别、年龄、身体质量指数(BMI)、手术前后可视化疼痛评分(VAS)、美国膝关节协会评分(KSS),比较两组间各个观察指标的差异,测量并比较手术前后及组间术侧屈膝90°、20°位置的伸膝肌力。采用SPSS19.0软件进行统计,定量资料采用独立样本t检验,定性资料采用卡方检验,P<0.05为有统计学意义。结果术后2周UKA组VAS评分显著低于TKA组,差异有统计学意义(t=7.098,P<0.01);在屈膝90°及20°位的伸膝肌力均显著高于TKA组,差异有统计学意义(t=5.290,9.165;P<0.01)。与术前相比,TKA组术后在屈膝90°与屈膝20°位置的伸膝肌力均明显减弱,差异有统计学意义(t=9.792,10.01;P<0.01)。结论与TKA手术相比,UKA术后早期疼痛轻,对伸膝肌力影响小。Objective To compare the influence of total knee arthroplasty （TKA） and unicompartmental knee arthroplasty （UKA） on post-operative extensional strength of knee. Methods Thirty-nine knees undergone TKA and thirty knees undergone UKA in the orthopedics department of the First Affiliated Hospital of Guangzhou Medical University were recorded and analyzed in this study from January 2015 to December 2016. All the cases were diagnosed as osteoarthritis. Sex, age, BMI index, pre- and post-operative visual analogue scale （VAS score）, American knee society knee score （KSS score） were compared between the two groups. Knee extension strength of the flexion positions at 20° and 90° were measured and compared. The calculations for continuous variables were performed with the independent samples t-test and Chi-square tests were used in case of dichotomous data by SPSS19. 0 software. A P value 〈 0.05 was considered to be significant. Results VAS score of the UKA group at two weeks after the surgery was significantly lower than that of the TKA group （ t = 7.098, P 〈 0.01 ） , and the extensional strength of knees at the flexion positions of 90°and 20°were significantly higher than those of the TKA group （ t = 5. 290, 9. 165 ; P 〈 0.01 ）. Compared to the value before the surgery, in the TKA group, the strength of extension at the flexion positions of 90° and 20° declined significantly （ t = 9. 792, 10.01 ; P 〈 0. 01 ）. Conclusion Compared to TKA, UKA presents less pain and less influence on extensional strength of knees.

关 键 词：关节成形术 置换 膝 四头肌 疼痛测定 

分 类 号：R687.4[医药卫生—骨科学]