两种术式治疗膝骨关节炎的疗效及改善足底压力情况比较  

Comparison of the curative effect of two surgical treatments for knee osteoarthritis and improvement situation of plantar pressure

作　　者：孟延丰 邹磊 王强 任国卫 陈雪荣[2] MENG Yan-feng;ZOU Lei;WANG Qiang;REN Guo-wei;CHEN Xue-rong(Dept of Orthopaedics,the Affiliated Hospital of Shaoxing University,Shaoxing Municipal Hospital,Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴文理学院附属医院(绍兴市立医院)骨科,浙江绍兴312000 [2]绍兴市人民医院骨科,浙江绍兴312000

出　　处：《临床骨科杂志》2022年第3期359-363,共5页Journal of Clinical Orthopaedics

基　　金：浙江省绍兴市科技局计划项目(编号:2018C30033)。

摘　　要：目的比较单髁膝关节置换术(UKA)与全膝关节置换术(TKA)治疗膝骨关节炎(KOA)的疗效及改善足底压力情况。方法将96例KOA患者按照术式不同分为UKA组(46例)和TKA组(50例)。比较两组手术情况,采用KSS评分、疼痛VAS评分、膝关节活动度(ROM)评价疗效,并记录足底压力改善情况。结果患者均获得随访,时间6~10(8.25±1.02)个月。切口长度、术中出血量、手术时间、术后引流量、住院时间UKA组明显短(少)于TKA组(P<0.01)。术后6个月两组KSS评分、疼痛VAS评分、ROM均明显优于术前(P<0.05);UKA组均明显优于TKA组(P<0.01)。两组10个足底区域达峰值压力(F_(Max))差值(术后6个月-术前)均为正值;第1趾区(Toe1)、第1~5跖骨区(M1~M5)、中足区(MF)的F_(Max)差值UKA组明显大于TKA组(P<0.05);第2~5趾区(Toe2~5)、足跟内区(HM)、足跟外区(HL)的F_(Max)差值两组比较差异均无统计学意义(P>0.05)。结论UKA、TKA均可有效治疗KOA,但UKA具有创伤小、疼痛轻、患者膝关节功能恢复快的优势,且更能明显改善患肢足底压力情况。Objective To compare the effect of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of knee osteoarthritis(KOA)and their improvement situation of plantar pressure.Methods The 96 KOA patients were divided into UKA group(46 cases)and TKA group(50 cases),according to different surgical procedures.The operation conditions of the two groups were compared,KSS score,pain VAS,and knee joint range of motion(ROM)were used to evaluate the curative effect,and the improvement situation of plantar pressure was recorded.Results All patients were followed up for 6~10(8.25±1.02)months.Incision length,intraoperative blood loss,operation time,postoperative drainage volume,and hospitalization time in the UKA group were significantly shorter(less)than those in the TKA group(P<0.01).At 6 months after surgery,the KSS score,pain VAS,and knee joint ROM of the two groups were significantly better than the preoperation(P<0.05);and the UKA group was significantly better than the TKA group(P<0.01).The maximal force(F_(Max))differences of the 10 plantar areas(the data of 6 months after surgery subtracted the preoperative)were all positive;the F_(Max)difference:the first toe area(Toe1),the first to fifth metatarsal area(M1~M5),the midfoot area(MF)in the UKA group were significantly greater than those in the TKA group(P<0.05);the second to fifth toe area(Toe2~5),the medial heel area(HM),and the external heel area(HL)of the two groups were not statistically significant(P>0.05).Conclusions Both UKA and TKA can effectively treat KOA,but UKA has the advantages of less trauma,less pain,and fast recovery of the patient’s knee joint function,and which can significantly improve the plantar pressure of the affected limb.

关 键 词：膝骨关节炎 单髁膝关节置换术 全膝关节置换术 足底压力 

分 类 号：R684.3[医药卫生—骨科学] R687.4[医药卫生—外科学]