膝骨性关节炎单髁置换是否联合关节镜清理比较  

Unicompartmental knee arthroplasty combined with or without arthroscopic debridement for knee osteoarthritis

作　　者：李永奎[1] 李正疆[1] 吉海波 班照楠[1] 邢叔星 黄强[1] LI Yong-kui;LI Zheng-jiang;JI Hai-bo;BAN Zhao-nan;XING Shu-xing;HUANG Qiang(Department of Orthopedics,The Fifth People's Hospital of Chengdu City,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院骨科,四川成都611130

出　　处：《中国矫形外科杂志》2021年第23期2118-2123,共6页Orthopedic Journal of China

摘　　要：[目的]比较单髁置换术(unicompartmental knee arthroplasty,UKA)联合关节镜清理与单纯UKA治疗膝骨性关节炎的中期疗效。[方法]2016年1月-2019年12月,共64例膝关节内侧室骨性关节炎患者纳人本研究,随机分为两组。其中,32例患者采用UKA联合关节镜清理术(联合组),32例患者采用单纯UKA进行治疗(单纯组),比较两组围手术期、随访和影像资料。[结果]两组间术中出血量、总失血量和住院时间的差异无统计学意义(P>0.05),但单纯组手术时间少于联合组(P<0.05)。随时间推移,两组患者VAS评分显著减少(P<0.05),而HSS评分和ROM显著增加(P<0.05)。术前至术后12个月,两组间VAS和HSS评分,以及ROM的差异均无统计学意义(P>0.05),但是术后18个月和末次随访时,联合组VAS评分、HSS评分和ROM均显著优于单纯组(P<0.05)。影像方面,与术前相比,两组患者术后FTA显著减小(P<0.05)、MPTA显示增大(P<0.05),而PTS两组均无改变(P>0.05)。术前两组间外侧室K-L分级的差异无统计学意义(P>0.05),但是末次随访时,联合组外侧室K-L分级显著优于单纯组(P<0.05)。[结论]UKA联合关节镜清理可同时精准处理内侧室与外侧间室病变,中期疗效优于单纯UKA。[Objective]To compare the mid-term clinical outcomes of unicompartmental knee arthroplasty(UKA)combined with or without arthroscopic debridement for knee osteoarthritis.[Method]From January 2016 to December 2019,a total of 64 patients with knee osteoarthritis were included in this study,and were randomly divided into two groups.Of them,32 patients were treated with UKA combined with arthroscopic debridement(the combined group),while the remaining 32 patients received UKA only(the simple group).The perioperative period,follow-up and imaging data were compared between the two groups.[Results]There were no statistically significant differences in term of intraoperative blood loss,total blood loss and hospital stay between the two groups(P>0.05),despite of the fact that the simple group consumed significantly less operation time than the combined group(P<0.05).The VAS scores decreased significantly(P<0.05),while the HSS scores and ROM increased significantly in both groups over time(P<0.05).Although no significant differences were found in VAS and HSS scores,as well as ROM between the two groups from the time point preoperatively to 12 months after surgery(P>0.05),the combined group proved significantly superior to the simple group in abovesaid items at 18 months postoperatively and at the latest follow-up(P<0.05).In term of imaging assessment,the femorotibial angle(FTA)decreased significantly(P<0.05),whereas the medial proximal tibial angle(MPTA)increased significantly(P<0.05),and the posterior tibial slope remained unchanged in both groups postoperatively compared with those before operation(P>0.05).There was no a statistically significant difference in the Kellgren-Lawrence grading of the lateral compartment between the two groups before operation(P>0.05),but the combined group was significantly superior to the simple group regarding the radiographic classification at the latest follow-up(P<0.05).[Conclusion]The UKA combined with arthroscopic debridement does treat the lesions on lateral and medial compartments si

关 键 词：膝骨性关节炎 内侧室 外侧室 单髁置换 关节镜清理术 

分 类 号：R684.3[医药卫生—骨科学]