单髁与全膝关节置换术治疗膝单间室骨关节炎的早期疗效比较  

Early efficacy of unicompartmental knee arthroplasty versus total knee arthroplasty in the treatment of unicompartmental knee osteoarthritis

作　　者：杨天翔 张博文 张晋宁 杨小春[2] 程萌旗[3] 陈德胜 YANG Tian-xiang;ZHANG Bo-wen;ZHANG Jin-ning;YANG Xiao-chun;CHENG Meng-qi;CEHN De-sheng(School of Clinical Medicine,Ningxia Medical University,Yinchuan,Ningxia 750004,China;Dept of Orthopaedics,the People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 750002,China)

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院骨三科,宁夏银川750004 [3]上海交通大学附属第六人民医院关节外科,上海200233 [4]宁夏回族自治区人民医院骨科,宁夏银川750002

出　　处：《临床骨科杂志》2023年第1期47-51,共5页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81760395,82060408);宁夏回族自治区科技厅重点研发计划项目(编号:2021BEG03049);宁夏回族自治区人社厅留学人员创新创业项目(编号:2020-75)。

摘　　要：目的比较单髁膝关节置换术(UKA)与全膝关节置换术(TKA)治疗膝单间室骨关节炎的早期疗效。方法将156例膝单间室骨关节炎患者根据手术方式不同分为UKA组(64例,采用UKA治疗)和TKA组(92例,采用TKA治疗)。记录两组围手术期相关指标,采用疼痛VAS评分、HSS评分评价膝关节疼痛和功能改善情况,术后3个月记录膝关节活动度和负重情况。结果患者均获得随访,时间3~12个月。血红蛋白及红细胞比容:术后第1、3天TKA组均显著低于UKA组(P<0.05)。总失血量、住院时间、术后输血率、深静脉血栓形成发生率:UKA组均少(低)于TKA组(P<0.05)。疼痛VAS评分:术后3 d两组比较差异无统计学意义(P>0.05)。HSS评分:术后3个月UKA组高于TKA组(P<0.01)。术后3个月,膝关节屈曲活动度UKA组大于TKA组(P<0.05),伸直活动度两组比较差异无统计学意义(P>0.05);两组患者均可全负重站立、正常行走,无需助行器辅助。结论UKA和TKA治疗膝单间室骨关节炎均可获得显著效果,但UKA手术创伤小、安全性高,更利于患者术后早期功能恢复。Objective To compare the early efficacy of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of unicompartmental knee osteoarthritis.Methods The 156 patients with unicompartmental knee osteoarthritis were divided into UKA group(64 cases,treated with UKA)and TKA group(92 cases,treated with TKA).Perioperative related indexes of the two groups were recorded.Pain VAS,HSS score were used to evaluate the situation of the knee joint pain and the function recovery,and the knee range of motion and weight-bearing were recorded at 3 months after operation.Results All patients were followed up for 3~12 months.Hemoglobin and hematocrit:TKA group were significantly lower than UKA group at 1,3 d postoperation(P<0.05).UKA group was less(lower)than TKA group in the total blood loss,length of hospital stay,postoperative blood transfusion rate and DVT formation incidence rate(P<0.05).There was no significant difference in pain VAS between the two groups at 3 d after surgery(P>0.05).HSS score of 3 months after operation was higher in UKA group than in that in the TKA group(P<0.01).At 3 months after surgery,knee flexion activity in the UKA group was larger than that in the TKA group(P<0.05),and there was no significant difference in extension activity between the two groups(P>0.05).All patients could stand with full weight-bearing and walk normally,without walking aids.Conclusions Both UKA and TKA have significant effects in the treatment of unicompartmental knee osteoarthritis,but UKA has less surgical trauma,higher safety,which is beneficial to postoperative early-term function recovery.

关 键 词：膝骨关节炎 单髁膝关节置换术 全膝关节置换术 围手术期失血量 

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