Oxford单髁与全膝关节置换治疗内侧膝骨关节炎的双中心对照研究  

A double center comparative study of Oxford unicompartment knee replacement and total knee arthroplasty in treatment of medial knee osteoarthritis

作　　者：刘志超 付立新[1] 崔彦江[1] 杨克强[1] 苗巍 张书钦[1] 李新[1] 马子龙 贾育松[3] 李晋玉[3] 郑晨颖[3] 张帆[3] 刘楚吟 袁巧妹 邸学士 康盛乾 陈江[3] LIU Zhichao;FU Lixin;CUI Yanjiang;YANG Keqiang;MIAO Wei;ZHANG Shuqin;LI Xin;MA Zilong;JIA Yusong;LI Jinyu;ZHENG Chenying;ZHANG Fan;LIU Chuyin;YUAN Qiaomei;DI Xueshi;KANG Shengqian;CHEN Jiang(First Department of Orthopedics,Southern District,Guang’anmen Hospital,China Academy of Traditional Chinese Medicine,Beijing 102600,China;Beijing Universi-ty of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院南区骨一科,北京102600 [2]北京中医药大学,北京100029 [3]北京中医药大学东直门医院骨伤科一区,北京100700

出　　处：《实用医学杂志》2021年第19期2487-2491,共5页The Journal of Practical Medicine

基　　金：青苗人才培养计划(编号:DZMYS-201702)。

摘　　要：目的对比观察Oxford单髁置换术(unicompartment knee replacement,UKR)与全膝关节置换术(total knee arthroplasty,TKA)治疗内侧膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法采用回顾性研究的方式,收集2015年6月至2019年6月在广安门医院南区骨一科和东直门医院骨伤一科行UKR或TKA的100例内侧KOA患者,按照手术方式分为单髁组50例和全膝组50例。比较UKR和TKA手术出血、手术时间和住院时间及术后1周、1个月、3个月、6个月与1年后膝关节屈曲度、VAS评分、HSS评分和并发症发生率。结果UKR手术出血量少于TKA,UKR手术时间以及住院时间短于TKA(P<0.05);UKR术后1周至1年膝关节屈曲度和HSS评分高于TKA,UKR术后VAS评分低于TKA(P<0.05);UKR临床疗效优良率术后1周至6月高于TKA(P<0.05),而术后1年的优良率差异无统计学意义(P>0.05);UKR和TKA术后相关并发症差异无统计学意义(P<0.05)。结论对于内侧KOA的患者TKA和UKR都是可行的治疗方案,术后一周至一年时间内UKR对于疼痛缓解及膝关节功能恢复效果更佳。Objective(UKR)and total knee arthroplasty(TKA)in the treatment of medial knee osteoarthritis.Methods patients with medial knee osteoarthritis who underwent UKR and TKA from June 2015 to June 2019 in the first department of orthopedics and orthopedics,Dongzhimen Hospital from June 2015 to June 2019 were selected and divided into single condyle group and total knee group,with 50 cases in each group.Intraoperative blood loss,postoperative total drainage volume,operation time and hospital stay,knee flexion,visual analogue scale(VAS),American hospital for Special Surgery knee score(HSS)and the incidence of related complications were compared between the two groups.Results condyle group were found and the operation time and hospitalization time were shorter than those in the total knee group,indicating statistical significance(P<0.05).Knee flexion and HSS score of single condyle group were higher than those of the total knee group from 1 week to 1 year after operation,but VAS score was lower and the difference was statistically significant(P<0.05).The excellent rate of clinical effect in single condyle group from 1 week to 6 months after the operation was higher in single condyle group(P<0.05)but no statistical difference was found 1 year after the operation(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P<0.05).Conclusion knee osteoarthritis.UKR has a better effect on pain relief and knee function recovery within 1 week to 1 year after operation.

关 键 词：内侧膝骨关节炎 单髁置换 全膝关节置换 

分 类 号：R684.3[医药卫生—骨科学]