膝关节单髁置换术治疗高龄膝关节内侧间室骨关节炎的临床研究  

A clinical study of unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis in advanced age patients

作　　者：熊昌军 左云周 严小康 王冠 付豪 姜学明 XIONG Changjun;ZUO Yunzhou;YAN Xiaokang;WANG Guan;FU Hao;JIANG Xueming(Wuhan Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine(The Affiliated Hospital of Wuhan Sports University),Wuhan 430079,Hubei,China)

机构地区：[1]武汉中西医结合骨科医院/武汉体育学院附属医院,湖北武汉430079

出　　处：《中医正骨》2025年第1期45-50,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)治疗高龄膝关节内侧间室骨关节炎的临床疗效和安全性。方法:回顾性分析2020年1月至2023年7月接受UKA治疗的80例膝关节内侧间室骨关节炎患者的病例资料,其中高龄组40例(年龄>75岁)、对照组40例(年龄55~75岁)。比较2组患者的住院时间、手术时间、术中出血量、术后引流量、并发症发生情况,以及术前和末次随访时膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、膝关节活动度、胫股角(femoral tibial angle,FTA)。结果:2组患者的住院时间、手术时间、术中出血量、术后引流量的组间差异均无统计学意义。80例患者均获随访,高龄组随访时间(19.75±5.10)个月,对照组随访时间(21.65±5.83)个月。末次随访时,2组患者的膝关节疼痛VAS评分均低于术前[(5.60±0.87)分,(1.33±0.66)分,t=-24.730,P=0.000;(5.63±0.98)分,(1.28±0.60)分,t=-23.942,P=0.000],HSS膝关节评分均高于术前[(51.50±5.75)分,(86.33±3.15)分,t=33.560,P=0.000;(51.98±5.44)分,(89.53±3.63)分,t=36.315,P=0.000],膝关节活动度均大于术前(100.70°±8.33°,117.13°±8.31°,t=8.831,P=0.000;99.88°±9.45°,116.75°±8.20°,t=8.528,P=0.000),FTA均小于术前(185.05°±3.62°,180.23°±2.45°,t=-6.974,P=0.000;184.95°±3.90°,180.03°±2.31°,t=-6.865,P=0.000);2组患者的膝关节疼痛VAS评分、膝关节活动度、FTA的组间差异均无统计学意义(t=-0.341,P=0.734;t=-0.198,P=0.844;t=-0.361,P=0.719);高龄组患者的HSS膝关节评分小于对照组(t=4.041,P=0.000)。2组患者术后并发症发生率比较,差异无统计学意义(χ^(2)=1.726,P=0.189)。结论:对于年龄>75岁的高龄膝关节内侧间室骨关节炎患者,采用UKA治疗可以缓解膝关节疼痛、改善膝关节活动度、纠正下肢力线和恢复膝关节功能,且安全性高;其膝关节功能恢复不如年龄55~75岁的�Objective:To explore the clinical outcomes and safety of unicompartmental knee arthroplasty(UKA)for treatment of medial compartment knee osteoarthritis(KOA)in advanced age patients.Methods:The medical records of 80 patients who underwent UKA for medial compartment KOA from January 2020 to July 2023 were retrospectively analyzed.The patients were divided into 2 groups according to the age,the ones aged over 75 years old were assigned into advanced-aged group(40 cases),and the ones ranged in age from 55 to 75 years old into control group(40 cases).The hospital stays,operative time,intraoperative blood loss,postoperative drainage volume,and complications were compared between the 2 groups.Furthermore,the knee pain visual analog scale(VAS)score,Hospital for Special Surgery(HSS)knee score,knee range of motion(ROM),and femoral tibial angle(FTA)measured before the surgery and at the last follow-up were also compared between the 2 groups,respectively.Results:There was no statistical difference in hospital stays,operative time,intraoperative blood loss,and postoperative drainage volume between the 2 groups.All patients in the 2 groups were followed up.The patients in the advanced-aged group were followed up for 19.75±5.10 months,and the ones in control group for 21.65±5.83 months.The knee pain VAS score and FTA decreased,while the HSS knee score and knee ROM increased at the last follow-up compared to pre-surgery in the 2 groups(5.60±0.87 vs 1.33±0.66 points,t=-24.730,P=0.000;5.63±0.98 vs 1.28±0.60 points,t=-23.942,P=0.000;185.05±3.62 vs 180.23±2.45 degrees,t=-6.974,P=0.000;184.95±3.90 vs 180.03±2.31 degrees,t=-6.865,P=0.000;51.50±5.75 vs 86.33±3.15 points,t=33.560,P=0.000;51.98±5.44 vs 89.53±3.63 points,t=36.315,P=0.000;100.70±8.33 vs 117.13±8.31 degrees,t=8.831,P=0.000;99.88±9.45 vs 116.75±8.20 degrees,t=8.528,P=0.000).Further comparison at the last follow-up revealed that there was no statistical difference in the knee pain VAS score,knee ROM and FTA between the 2 groups(t=-0.341,P=0.734;t=-0.198,P=0.

关 键 词：骨关节炎 膝 关节成形术 置换 膝 高龄 

分 类 号：R687.4[医药卫生—骨科学]