胫骨高位截骨术与单髁置换术治疗膝骨关节炎近期疗效观察  

Comparison of High Tibial Osteotomy and Unicompartmental Knee Arthroplasty in Treatment of Knee Osteoarthritis

作　　者：赵志[1] 周新社[1] 吴敏[1] 官建中[1] 王志岩[1] 裴立家 ZHAO Zhi;ZHOU Xin-she;WU Min;GUAN Jian-zhong;WANG Zhi-yan;PEI Li-jia(Department of Orthopaedics,The First Affiliated Hospital of BengBu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院骨科,安徽蚌埠233004

出　　处：《河北北方学院学报（自然科学版）》2021年第4期15-19,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的探讨胫骨高位截骨术(high tibial osteotomy,HTO)与单髁置换术(unicompartmental knee arthroplasty,UKA)治疗膝关节内侧间室骨关节炎的近期疗效,为临床治疗提供参考。方法29例膝关节内侧间室骨关节炎患者根据患者意愿分为2组,14例患者采用胫骨高位截骨术(HTO组)治疗,15例患者采用单髁膝关节置换术(UKA组)治疗,2组患者性别、年龄、术前关节X线分级,VAS、IKDC、Lysholm、KOOS、HSS比较差异无统计学意义(P>0.05),具有可比性。结果2组患者术中出血量、手术时间比较差异无统计学意义(P>0.05),术后7 d时VAS、IKDC、Lysholm、KOOS、HSS显著优于术前(P<0.05);2组患者术后VAS、IKDC、Lysholm、KOOS、HSS组间比较差异无统计学意义(P>0.05)。2组患者术前胫股角测量差异无统计学意义(P>0.05),术后7d与术前比较差异均有统计学意义(P<0.05),组间差异无统计学意义(P>0.05)。结论HTO及UKA治疗膝关节骨性关节炎近期效果相近,均能获得满意临床疗效,临床实践中应综合考虑患者年龄、病变程度、从事职业、术后需求等因素选择合适的治疗方式,远期疗效有待进一步观察。Objective To investigate the efficacy of high tibial osteotomy and unicompartmental knee arthroplasty(UKA)in the treatment of knee medial compartment osteoarthritis.Methods A total of 29 patients with medial compartment osteoarthritis were divided into two groups according to their wishes.14 patients were treated with high tibial osteotomy(HTO group)and 15 patients with unicompartmental knee arthroplasty(UKA group).The clinical effects of the two groups were compared.Results There were no significant differences in gender,age,preoperative joint X-ray grading,VAS,IKDC,Lysholm,KOOS and HSS between the two groups(P>0.05).There was no significant difference in blood loss and operation time between the two groups(P>0.05).Postoperative Vas,IKDC,Lysholm,KOOS and HSS were significantly better than those before 7 days(P<0.05),but there was no significant difference between groups(P>0.05).There was no significant difference in the measurement of tibiofemoral angle between the two groups before operation(P>0.05),but there was significant difference in the data between preoperation and postoperative 7 days(P<0.05)and there was no significant difference between the two groups(P>0.05).Conclusion HTO and UKA have similar short-term effects in the treatment of knee osteoarthritis,and both can obtain satisfactory clinical effects.In clinical practice,we should comprehensively consider the patient's age,disease degree,occupation,postoperative needs and other factors to select the appropriate treatment method,and the long-term efficacy needs to be further observed.

关 键 词：胫骨高位截骨术 单髁置换术 膝关节内侧间室骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]