生物型与骨水泥型股骨髁假体单髁置换治疗膝关节内侧间室骨关节炎的比较  

Comparison of cementless and cemented femoral prosthesis for unicompartmental knee arthroplasty in the treatment of osteoarthritis

作　　者：史思峰 林强 周冰 陈向阳 卢文海 Shi Sifeng;Lin Qiang;Zhou Bing;Chen Xiangyang;Lu Wenhai(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221400,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院,江苏省徐州市221400

出　　处：《中国组织工程研究》2023年第18期2848-2853,共6页Chinese Journal of Tissue Engineering Research

基　　金：江苏省自然科学基金(BK20140220),项目负责人:史思峰。

摘　　要：背景:生物型单髁置换假体的应用在临床上逐渐流行,但是其临床应用效果仍然存在争论。目的:对比生物型和骨水泥型股骨髁假体单髁置换治疗膝关节前内侧骨关节炎的早期临床效果。方法:选择2020年1月至2021年1月徐州医科大学附属医院骨关节科收治的膝关节内侧间室骨关节炎患者62例,按照随机数字表法分为2组,其中骨水泥组31例,生物型组31例,两组均进行单髁置换治疗。记录术后目测类比评分、膝关节活动度、美国特种外科医院功能评分及患者满意度,进行统计学评价。结果与结论:(1)两组患者在术后1,3,6个月膝关节活动度、术后6个月美国特种外科医院功能评分优良率及患者满意度方面相比,差异无显著性意义(P>0.05);(2)骨水泥组在术后1,3个月时静息状态下目测类比评分优于生物型组(P<0.05);术后3个月时活动状态下目测类比评分优于生物型组(P<0.05);(3)所有患者无术后感染及深静脉血栓发生,有2例患者术后伤口延迟愈合,经换药治疗后伤口痊愈;(4)提示生物型股骨假体单髁置换治疗前内侧骨关节炎安全有效,与骨水泥型股骨假体相比虽然在术后早期对疼痛的缓解较差,但2种假体在术后膝关节活动度、膝关节临床功能方面具有同等效果;对于高龄骨质疏松患者作者推荐选择骨水泥假体。BACKGROUND:The application of cementless unicompartmental knee arthro plasty is becoming increasingly popular,but its clinical result is still controve rsial.OBJECTIVE:To compare the clinical res ult of the cementless and the cemented femoral prosthesis in unicompartmental knee arthro plasty in the treatment of ante romedial knee osteoarthritis.METHODS:From January 2020 to January 2021,62 patients with medial compartmental osteoarthritis of the knee we re enrolled in the Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,and randomly allocated to 2 groups,including 31 cases in the cemented group and 31 cases in the cementless group.Patients we re all treated with unicompartmental knee arthroplasty.The postoperative visual analogue scale score,range of motion of the knee,Hos pital for Special Su rgery score and patient satisfa ction were recorded for statistical evaluation.RESULTS AND CONCLUSION:(1)There was no significant difference in knee range of motion at 1,3,and 6 months after surgery,excellent and good rate of Hospital for Special Su rgery score and patient satisfaction at 6 months after surgery between the two groups(P>0.05).(2)The visual analogue scale score of the cemented group was better than that of the cementless group at 1 and 3 months at rest(P<0.05);the visual analogue scale score on activity was better in the cemented group than that of the cementless group at 3 months(P<0.05).(3)There was no postoperative infection or deep vein thrombosis.There were two patients with delayed wound healing,and wound healed after dressing change.(4)It is suggested that cementless femoral prosthesis for unicompartmental knee arthroplasty was safe and effective in the treatment of medial osteoarthritis.Compared with cemented femoral prostheses,although pain relief was less in the early postoperative period,two prostheses have the same effect on postoperative knee range of motion and clinical function of the knee.For elderly patients with osteoporosis,the authors recommend the cemented unicomp

关 键 词：单髁置换 膝关节 单间室 关节炎 生物型假体 骨水泥假体 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R684