一期双侧膝关节内侧单间室置换的安全性研究  

Safety of one-stage bilateral unicompartmental knee arthroplasty

作　　者：丁昕 杜瑞 王渭君 蒋青[1,2,3] DING Xin;DU Rui;WANG Weijun;JIANG Qing(Orthopedic Center,Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University,Nanjing,Jiangsu 210008,China;Division of Sports Medicine and Adult Reconstructive Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008;Branch of National Clinical Research Center for Orthopedics,Sports Medicine and Rehabilitation,Nanjing,Jiangsu 210008)

机构地区：[1]徐州医科大学南京鼓楼临床学院骨科中心,江苏南京210008 [2]南京大学医学院附属鼓楼医院运动医学与成人重建外科,江苏南京210008 [3]国家骨科与运动康复临床医学研究中心分中心,江苏南京210008

出　　处：《徐州医科大学学报》2024年第9期686-691,共6页Journal of Xuzhou Medical University

基　　金：国家自然科学基金(81991514)。

摘　　要：目的探讨一期双侧膝关节内侧单间室置换(OB-UKA)的安全性。方法回顾性分析2021年1月—2023年1月在南京鼓楼医院进行OB-UKA手术的35例膝关节骨性关节炎患者的临床资料,并在同期行单侧膝关节内侧单间室置换(UKA)和单侧全膝关节置换(TKA)的患者中选择年龄、性别匹配者各35例作为对照,比较3组患者手术相关指标(手术时间、总失血量、住院时间)、营养状态[血红蛋白(Hb)、白蛋白(ALB)]、炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)]、疼痛程度、膝关节功能评分及并发症。结果术前3组间一般资料的差异无统计学意义(P>0.05)。OB-UKA组手术时间较UKA组和TKA组长(P<0.05),总失血量与TKA组比较差异无统计学意义(P>0.05),明显高于UKA组(P<0.05);术后OB-UKA组和UKA组Hb、ALB比较差异无统计学意义(P>0.05);OB-UKA组和TKA组术后WBC、CRP比较差异无统计学意义(P>0.05);OB-UKA组术后视觉模拟评分(VAS)与UKA组比较差异无统计学意义(P>0.05),明显低于TKA组(P<0.05);OB-UKA组美国特种外科医院膝关节功能评分(HSS)与UKA组比较差异无统计学意义(P>0.05),但明显高于TKA组(P<0.05);UKA组、OB-UKA组并发症发生率均为2.9%,低于TKA组并发症发生率(5.7%)(P<0.05)。结论OB-UKA与UKA相比,手术时间延长,失血量增加,但术后营养相关指标与UKA水平相似,疼痛程度较低,膝关节功能评分与UKA相当。此外,OB-UKA术后炎症相关指标与TKA水平相似,围术期并发症发生率低于TKA,且与UKA相似。OB-UKA可以作为双膝内侧间室退变患者的安全有效的首选术式。Objective To explore the safety of one-stage bilateral unicompartmental knee arthroplasty(OB-UKA).Methods A total of 35 patients who underwent OB-UKA at Nanjing Drum Tower Hospital from January 2021 to January 2023 were selected and their clinical data were retrospectively analyzed.Meanwhile,another 35 age-and gender-matched patients each from those who underwent unilateral UKA and unilateral total knee arthroplasty(TKA)were selected as controls.The three groups were compared for surgery-related indicators(operation time,total blood loss,and the length of hospitalization stay),nutritional status〔hemoglobin(Hb)and albumin(ALB)〕,inflammatory markers〔white blood cell count(WBC)and C-reactive protein(CRP)〕,pain levels,knee function scores,and complications.Results There were no statistical differences in general information among the three groups before surgery.The OB-UKA group showed longer operation time than the UKA and TKA groups(P<0.05).The OB-UKA group also presented significantly higher total blood loss than the UKA group,without statistical difference compared with the TKA group(P>0.05).There were no statistical differences in postoperative Hb and ALB between the OB-UKA and UKA groups(P>0.05).There were no statistical differences in postoperative WBC and CRP between the OB-UKA and TKA groups(P>0.05).The postoperative visual analog scale(VAS)score in the OB-UKA group showed no significant difference from the UKA group but was significantly lower than the TKA group(P<0.05).The Hospital for Special Surgery(HSS)knee function score of the OB-UKA group was comparable to the UKA group but significantly higher than the TKA group(P<0.05).The incidence of complications in the UKA and OB-UKA groups was 2.9%each,both lower than 5.7%observed in the TKA group(P<0.05).Conclusions Compared with UKA,OB-UKA is associated with longer operation time and increased blood loss.However,its postoperative nutritional indicators are similar to those of the UKA group,with reduced pain levels and comparable functional outcomes.Ad

关 键 词：单髁膝关节置换 全膝关节置换术 同期手术 膝关节骨性关节炎 安全性 

分 类 号：R684.3[医药卫生—骨科学]