膝内侧间室骨关节炎的治疗方法选择  

Selection of treatment methods for the medial knee osteoarthritis

作　　者：马峰[1] 才智[1] MA Feng;CAI Zhi(Department of Osteology,Haigang Hospital of qinhuangdao City,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市海港医院骨一科,066000

出　　处：《河北医药》2019年第5期703-706,共4页Hebei Medical Journal

摘　　要：目的比较单髁关节置换术(UKA)、全膝关节置换术(TKA)及胫骨高位截骨术(HTO)在治疗膝关节内侧间室骨关节炎的治疗方法选择及术后疗效。方法收治的186例(216膝)膝内侧间室骨关节炎患者按照手术适应证分成UKA组41例(56膝)、TKA组74例(80膝)和HTO组71例(80膝)。比较3组手术时间、术中出血量、术后负压引流总量和住院天数。采用膝关节HSS评分、膝关节活动度(ROM)评价手术效果。结果患者均获得满意随访,时间24～36个月。UKA组手术时间、术中出血量、术后引流量、住院天数均低于TKA组及HTO组,差异均有统计学意义(P<0.01)。术后6周,UKA组及HTO组的HSS评分及ROM均高于TKA组,差异均有统计学意义(P<0.05)。结论 UKA治疗内侧间室膝骨关节炎是安全有效的方法,术后功能优于TKA及HTO,HTO治疗年轻患者术后功能相比于TKA具有一定的优势;严格把握手术适应证是治疗膝内侧间室骨关节炎的关键。Objective To investigate the selection and the postoperative effects of unicompartmental knee arthroplasty(UKA),total knee arthroplasty(TKA)and high tibial osteotomy(HTO)in treatment of medial knee osteoarthritis.Methods A total of 186 patients(216 knee joints)with medial knee osteoarthritis were divided into UKA group,TKA group and HTO group according to the operation methods.The curative effects were evaluated according to operation time,intraoperative blood loss,postoperative drainage volume,hospitalization days,KSS scores and range of motion(ROM).Results All the patients were followed up for 24~36 months.The operation time,intraoperative blood loss,postoperative drainage volume,hospitalization days in UKA group were significantly lower than those in TKA group and HTO group(P<0.01).At 6 weeks after surgery the KSS scores and ROM in UKA group and HTO group were significantly higher those in TKA group(P<0.05).Conclusion UKA is a safe and effective method in treatment of medial knee oateoarthritis,which is superior to TKA and HTO in postoperative functions for younger patients.It is the key to control the surgical indications strictly in treatment of medial knee oateoarthritis.

关 键 词：单髁置换术 全膝关节置换术 胫骨高位截骨术 膝内侧间室骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]