单髁置换术与全膝置换术治疗高龄患者膝关节内侧单间室骨关节炎的近期疗效比较  

Comparison of short-term effect between unicompartmental knee arthroplasty and total knee arthroplasty in the treatment of single-compartment osteoarthritis of the medial knee in elderly patients

作　　者：吕欣[1] 苏日娜[2] 孙智文[1] 张爱民[1] 张志峰[3] Lyu Xin;Su Rina;Sun Zhiwen;Zhang Aimin;Zhang Zhifeng(Department of Orthopedics,Chifeng Municipal Hospital,Chifeng 024000,China;Department of Anesthesiology,Chifeng Municipal Hospital,Chifeng 024000,China;Department of Orthopedics,Second Affiliated Hospoital of Inner Mongolian Medical University,Huhhot 010030,China)

机构地区：[1]赤峰市医院骨关节科,024000 [2]赤峰市医院麻醉科,024000 [3]内蒙古医科大学第二附属医院骨关节科,呼和浩特010030

出　　处：《中华损伤与修复杂志（电子版）》2021年第6期471-477,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：内蒙古自治区自然科学基金项目(2020MS08144);内蒙古自治区赤峰市科研课题立项项目(SZR156)。

摘　　要：目的比较单髁关节置换术(UKA)与全膝关节置换术(TKA)治疗高龄膝关节内侧单间室骨关节炎患者的近期临床疗效,为手术方案选择提供参考依据。方法回顾性分析赤峰市医院骨关节科2014年12月至2018年12月应用第3代Oxford单髁系统行UKA治疗的高龄膝内侧单间室骨关节炎患者40例(40膝),设为UKA组;并随机选取同期行TKA治疗的高龄膝内侧单间室骨关节炎患者40例(40膝),设为TKA组。UKA组患者行膝关节内侧单间室置换术,术中保留其他间室的软骨、外侧半月板及前、后交叉韧带,安装部分型膝关节假体(第3代Oxford单髁假体)。TKA组行TKA,术中切除内、外侧间室软骨,内、外侧半月板及前、后交叉韧带,安装全膝关节假体(Nexgen假体)。2组患者于术后3、6、12个月行门诊随访,比较术前与末次随访时美国特种外科医院(HSS)评分、视觉模拟评分法(VAS)评分、膝关节活动度、血红蛋白以及术后并发症、输血率及患者住院时间相关指标。数据行t检验、χ^(2)检验。结果2组患者全部获得随访,所有患者均随访至术后12个月,以末次随访结果为准。2组患者术前HSS评分、VAS评分、膝关节活动度、血红蛋白比较,差异均无统计学意义(P>0.05)。2组患者末次随访时HSS评分、VAS评分、膝关节活动度、血红蛋白较术前均有明显改善,差异均有统计学意义(P<0.05)。末次随访时,UKA组患者HSS评分、VAS评分分别为(88.7±4.5)、(1.5±0.3)分,与TKA组[(87.1±5.1)、(1.8±0.4)分]比较,差异均无统计学意义(P>0.05);UKA组患者的膝关节活动度为(121.3±8.4)°,优于TKA组[(110.2±9.6)°],差异有统计学意义(P<0.05),TKA组的血红蛋白为(91.1±16.0)g/L,较UKA组[(106.5±15.8)g/L]下降,差异有统计学意义(P<0.05);UKA组并发症发生率为3例(7.5%),要明显低于TKA组[10例(25.0%)],差异有统计学意义(P<0.05);TKA组输血率为35例(87.5%),要明显高于UKA组[2例(5.0%)],差异有统计学意义(P<Objective To compare the short-term effect between unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of single-compartment osteoarthritis of the medial knee in elderly patients,and to provide a reference for surgical options.Methods A retrospective analysis was conducted on 40 elderly patients(40 knees)with medial single-compartment osteoarthritis of the knee using the third-generation Oxford unicompartmental system in the Department of Osteoarthritis,Chifeng Municipal Hospital from December 2014 to December 2018,and set them as the UKA group.A total of 40 elderly patients with medial compartment osteoarthritis of the knee(40 knees)who received TKA treatment at the same time were selected as the TKA group.Patients in the UKA group underwent medial unicompartmental knee arthroplasty.During the operation,cartilage in other compartments,lateral meniscus,anterior and posterior cruciate ligaments were preserved,and partial knee prosthesis(the third-generation Oxford single condyle prosthesis)were installed.Patients in the TKA group underwent TKA,in which the cartilage,medial and lateral meniscus and anterior and posterior cruciate ligaments of the medial and lateral compartments were removed,and a total knee prosthesis(Nexgen prosthesis)was installed.The two groups of patients underwent outpatient follow-up at 3,6,and 12 months after surgery.The hospital for special surgery(HSS)score,visual analogue score(VAS),knee joint range of motion,hemoglobin were observed and recorded before and at the last follow-up.The postoperative complications,blood transfusion rate and length of hospital stay were compared between the two groups.Data wasprocessed with t test,chi-square test.Results All patients in the two groups were followed-up,and all patients were followed-up to 12 months after surgery,and the results of the last follow-up were taken as the criterion.There were no statistically significant differences in HSS score,VAS score,knee joint range of motion,and hemoglobin between the two g

关 键 词：关节成形术 置换 膝 骨关节炎 老年人 单髁置换 

分 类 号：R68[医药卫生—骨科学]