单髁与全膝关节置换术对内侧单间室膝退行性骨关节炎临床疗效分析  

Clinical Efficacy of Single Condyle and Total Knee Arthroplasty for Knee Osteoarthritis in the Medial Single Compartment

作　　者：胡建平 李俊峰 王建华 秦鸿雁 于吉文[4] HU Jian-ping;LI Jun-feng;WANG Jian-hua;IN Hong-yan;YU Ji-wen(Department of Orthopedics,Section One,Shanting Hospital,Zaozhuang,Shandong Province,277200 China;Department of Orthopedics,Section Three,Shanting Hospital,Zaozhuang,Shandong Province,277200 China;Department of Orthopedics,Zaozhuang Municipal Hospital,Zaozhuang,Shandong Province,277100 China;Department of Traumatic Orthopedics,Lianyungang First People’s Hospital,Lianyungang,Jiangsu Province,222000 China)

机构地区：[1]山东省枣庄市山亭医院骨一科,山东枣庄277200 [2]山东省枣庄市山亭医院骨三科,山东枣庄277200 [3]山东省枣庄市市立医院骨科,山东枣庄277100 [4]连云港市第一人民医院创伤骨科,江苏连云港222000

出　　处：《中外医疗》2018年第4期4-8,共5页China & Foreign Medical Treatment

摘　　要：目的比较单髁置换术(Unilateral Knee arthroplasty,UKA)与全膝关节置换术(Total knee arthroplasty,TKA)治疗膝关节内侧单间室退行性骨关节炎(Inner compartment of Knee osteoarthritis,ICKOA)的疗效。方法回顾性分析山东省枣庄市山亭医院2005年5月—2012年12月收治的ICKOA行手术治疗患者176例,按手术方式将患者分为UKA组与TKA组,比较2组的临床疗效。结果总共有83例患者完成了UKA手术,93例患者完成了TKA手术(其中5例术前准备行UKA,术中改为TKA),均获得平均19(15~24)个月随访,其中UKA组并发症2例(2.41%),TKA组并发症5例(5.38%),2者比较差异无统计学意义(P>0.05)。两组患者手术时间比较,差异无统计学意义(P>0.05),但UKA组术中出血量(123.47±13.36)m L、术后1 d VAS评分(2.65±1.26)、首次直腿抬高时间(1.05±1.08)d、住院时间(5.35±1.18)d均显著少于TKA组[(262.63±25.18)m L、(3.14±1.42)分、(2.24±1.45)d、(7.34±1.52)d](P<0.05)。2组术后1年HSS评分、膝关节活动度与术前比较明显提高(P<0.05),而两组术前HSS评分、膝关节活动度差异无统计学意义(P>0.05)。结论 UKA与TKA治疗ICKOA均能够有效改善患者膝关节功能,UKA术中创伤小,更有利于患者术后的恢复,但需严格筛选病例,排除前交叉韧带功能不全患者,TKA虽有效,但应遵循膝关节炎阶梯治疗原则,避免扩大手术。Objective This paper tries to compare the effects of Unilateral Knee arthroplasty(UKA)and Total knee arthroplasty(TKA)on the treatment of intraventricular compartment osteoarthritis(ICKOA)in the medial compartment of the knee Efficacy.Methods A retrospective analysis of this hospital from May 2005 to December 2012 of ICKOA surgical treatment of 176 patients was conducted,according to surgical methods,they were divided into UKA group and TKA group,compared the clinical efficacy of the two groups.Results A total of 83 patients underwent UKA surgery and 93 patients completed TKA surgery(5 in preoperative UKA and TKA during surgery),all with an average of 19(15~24)months of follow-up,with UKA Complication in 2 cases(2.41%),TKA group complications in 5 cases(5.38%),the difference was not statistically significant(P>0.05).There was no significant difference in operative time between the two groups(P>0.05).However,the intraoperative blood loss(123.47±13.36)mL in UKA group and VAS score(1.65±1.26)points,the first straight leg time(1.05±1.08)d and hospital stay(5.35±1.18)d were significantly lower than those in the TKA group[(262.63±25.18)mL,(3.14±1.42)points,(2.24±1.45)d,(7.34±1.52)d,respectively](P<0.05).There was no significant difference between the two groups in HSS score and knee activity before surgery(P>0.05).Conclusion UKA and TKA can effectively improve the knee function of the patients in the medial interventricular unit of knee joint.However,the wound in UKA is less favorable for the postoperative recovery.TKA is more suitable for patients with anterior cruciate ligament.

关 键 词：全膝关节置换术 单髁置换术 内侧单间室 膝关节骨关节炎 

分 类 号：R4[医药卫生—临床医学]