开放楔形胫骨高位截骨术与膝单髁置换术治疗K-LⅢ级膝内侧间室骨关节炎的术后运动功能比较  

The motion function analysis after high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of K-L grade Ⅲ medial compartment osteoarthritis of the knee joint

作　　者：王宏庆 董婕[1] 梁庆晨 于振国 孙凤龙[1] WANG Hongqing;DONG Jie;LIANG Qingchen;YU Zhenguo;SUN Fenglong(Department of Orthopaedics,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院骨科,北京100144

出　　处：《中华骨与关节外科杂志》2024年第5期423-430,共8页Chinese Journal of Bone and Joint Surgery

基　　金：国家重点研发计划(2023YFC2414103)。

摘　　要：目的:比较开放楔形胫骨高位截骨术(HTO)与膝单髁置换术(UKA)治疗K-LⅢ级膝内侧间室骨关节炎(OA)患者术后膝关节运动功能恢复情况。方法:选取2017年1月至2020年12月行HTO和UKA治疗的K-LⅢ级膝关节内侧间室OA患者各50例进行分析。术后根据膝关节损伤及骨关节炎后果评分(KOOS)、体育活动等级量表(PARS-3)评分及Tegner膝关节运动水平评分,分别从运动损伤情况、运动量、运动能力三个方面对运动功能进行评估。结果:HTO组患者随访时间24~45个月,平均(31.1±4.3)个月;UKA组患者随访时间24~38个月,平均(29.8±3.5)个月。术后3个月、6个月,UKA组患者KOOS、PARS-3评分、Tegner膝关节运动水平评分显著高于HTO组(P均<0.05);术后12个月、24个月,两组患者间各评分差异无统计学意义(P均>0.05)。UKA组患者在恢复到OA发病前运动量及运动能力方面所需时间明显短于HTO组(P均<0.05);与UKA组相比,HTO组患者在2年内实现更高级别运动量和运动能力的患者更多(P均<0.05)。结论:对于K-LⅢ级膝内侧间室OA患者,UKA术后早期能够更快地恢复膝关节运动功能。术后2年,HTO在实现更高级别运动量和运动能力方面更具有优势。Objective:This study aimed to compare the motion function outcomes following high tibial osteotomy(HTO)and unicompartmental knee arthroplasty(UKA)in patients with K-L grade Ⅲ medial compartment knee osteoarthritis(OA).Method:A retrospective analysis was conducted on patients with K-L grade Ⅲ medial compartment OA who underwent either HTO or UKA from January 2017 to December 2020.The patients were matched by age and gender.Motor function was evaluated based on the knee injury and osteoarthritis outcome score(KOOS),physical activity rating scale(PARS-3)and Tegner activity scale,assessing sports injury,exercise volume and motor ability.Results:The follow-up time for the HTO group was 24-45 months,with an average of(31.1±4.3)months;The follow-up time for the UKA group was 24-38 months,with an average of(29.8±3.5)months.At 3 and 6 months postoperatively,the UKA group exhibited significantly higher KOOS,PARS-3,and Tegner activity scores compared to the HTO group(all P<0.05).However,at 12 and 24 months postoperatively,there were no significant differences in the scores between the two groups(all P>0.05).The UKA group required significantly less time to return to pre-disease levels of exercise volume and motor ability compared to the HTO group(both P<0.05).Compared to the UKA group,a greater number of patients in the HTO group achieved higher levels of exercise volume and motor ability within 2 years(both P<0.05).Conclusions:For patients with K-L grade Ⅲ medial compartment OA,UKA provides quicker recovery of knee joint motor function in the early postoperative period.However,at 2 years postoperatively,HTO demonstrated superior outcomes in achieving higher levels of exercise volume and motor ability.

关 键 词：膝骨关节炎 胫骨高位截骨术 膝单髁置换术 运动功能 运动量 运动能力 

分 类 号：R681[医药卫生—骨科学]