体质量指数对单髁膝关节置换术短中期疗效的影响  

Effect of body mass index on short-and medium-term effectiveness of unicompartmental knee arthroplasty

作　　者：郑冲 卢伟杰[1] 李之琛[1] 周俊洁 陈东峰[1] 吴颖斌 ZHENG Chong;LU Weijie;LI Zhichen;ZHOU Junjie;CHEN Dongfeng;WU Yingbin(Department of Orthopedic Arthrosurgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong,510000,P.R.China)

机构地区：[1]广州医科大学附属第一医院骨关节外科,广州510000 [2]昆明医科大学第一附属医院骨科,昆明650032

出　　处：《中国修复重建外科杂志》2020年第4期442-446,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨体质量指数(body mass index,BMI)对膝关节前内侧间室骨关节炎患者单髁膝关节置换术(unicompartmental knee arthroplasty,UKA)短中期疗效的影响。方法回顾分析2014年5月—2019年5月采用UKA治疗的55例(61膝)膝关节前内侧间室骨关节炎患者临床资料,根据BMI将患者分为3组:正常体质量组(A组,BMI 18.50~24.99 kg/m^2)23例(25膝),超重组(B组,BMI 25.00~29.99 kg/m^2)23例(25膝),肥胖组(C组,BMI 30.00~39.99 kg/m^2)9例(11膝)。3组患者性别、年龄、侧别、病程及术前美国特种外科医院(HSS)评分、疼痛视觉模拟评分(VAS)、膝关节活动度(range of motion,ROM)比较差异均无统计学意义(P>0.05)。记录并比较3组患者手术时间、术中显性失血量及术后1周血红蛋白下降量;手术前后采用HSS评分、VAS评分及ROM评价膝关节功能及疼痛改善情况。结果3组患者手术时间、术中显性失血量及术后1周血红蛋白下降量比较差异均无统计学意义(P>0.05)。55例患者均获随访,随访时间5~60个月,平均24个月。术后均无感染、脂肪栓塞及下肢深静脉血栓形成等并发症发生。膝关节正侧位X线片显示未出现假体脱位及松动,假体位置良好。末次随访时,3组HSS评分、VAS评分及ROM均较术前显著改善,差异有统计学意义(P<0.05);但3组间各指标比较差异均无统计学意义(P>0.05)。结论对于肥胖和超重的膝关节单间室骨关节炎患者,采用UKA术后可获满意短中期疗效,远期疗效尚需进一步随访观察。Objective To investigate the effect of body mass index(BMI)on the short-and medium-term effectiveness of unicompartmental knee arthroplasty(UKA)in the treatment of anterior medial compartmental osteoarthritis of knee joint.Methods The clinical data of 55 patients(61 knees)with anterior medial compartmental osteoarthritis of knee joint treated with minimally invasive UKA between May 2014 and May 2019 were retrospectively analyzed.According to BMI,the patients were divided into 3 groups:normal body mass group[group A,BMI 18.50-24.99 kg/m^2,23 cases(25 knees)],overweight group[group B,BMI 25.00-29.99 kg/m^2,23 cases(25 knees)],obesity group[group C,BMI 30.00-39.99 kg/m^2,9 cases(11 knees)].There was no significant difference in gender,age,sides,disease duration,and preoperative American Special Surgery Hospital(HSS)score,pain visual analogue scale(VAS)score,and knee range of motion(ROM)among 3 groups(P>0.05).The operation time,intraoperative dominant blood loss,and the postoperative decreased amount of hemoglobin at 1 week were recorded and compared among 3 groups.The HSS score,VAS score,and ROM were used to evaluate the knee function and pain improvement.Results There was no significant difference in the operation time,the intraoperative dominant blood loss,and the postoperative decreased amount of hemoglobin at 1 week among 3 groups(P>0.05).All the 55 patients were followed up 5-60 months,with an average of 24 months.No complication such as infection,fat embolism,or deep venous thrombosis of lower extremity occurred after operation.The anteroposterior and lateral X-ray films of the knee joint showed that no dislocation or loosening of the prosthesis occurred and the position of the prosthesis was good.At last follow-up,the HSS score,VAS score,and ROM of the 3 groups were significantly improved when compared with preoperative ones(P<0.05);but there was no significant difference among 3 groups(P>0.05).Conclusion For obese and overweight patients with anterior medial compartmental osteoarthritis of the knee joint,the

关 键 词：单髁膝关节置换术 前内侧间室骨关节炎 体质量指数 膝关节 

分 类 号：R687.4[医药卫生—骨科学]