膝关节内侧间室重度骨关节炎老年患者人工单髁关节置换术后下肢负荷及不良预后分析  

Postoperative Analysis of Limb Load and Adverse Prognosis in Elderly Patients with Severe Medial Compartment Knee Osteoarthritis Undergoing Unicompartmental Knee Arthroplasty

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作  者:李振杰 姜志圣[1] LI Zhenjie;JIANG Zhisheng(Department of Orthopedics II,Puyang Traditional Chinese Medicine Hospital,Puyang Henan 457000,China)

机构地区:[1]濮阳市中医院骨二科,河南濮阳457000

出  处:《临床研究》2025年第5期74-78,共5页Clinical Research

摘  要:目的观察膝关节内侧间室重度骨关节炎(KOA)老年患者膝关节单髁置换术(UKA)术后下肢负荷及不良预后,为临床提供参考。方法选取2022年6月至2023年6月濮阳市中医院收治的89例KOA老年患者为研究对象,按照随机数表法分为对照组(44例)和试验组(45例)。对照组患者给予全膝关节置换术治疗,试验组患者给予UKA治疗。比较两组患者中文版奎森炎症指数(Lequesne指数)评分、膝关节侧间室应力负荷、Berg平衡量表(BBS)评分和并发症发生情况,分析比较BMI亚组对整体并发症的影响。结果术后,两组患者中文版Lequesne指数评分均降低,且试验组低于对照组,差异有统计学意义(P<0.05)。术后,两组患者膝关节峰值内收力矩(KAM)、膝关节峰值屈曲力矩(KFM)水平均升高,且试验组高于对照组,差异有统计学意义(P<0.05)。术后,两组患者BBS评分均升高,且试验组高于对照组,差异有统计学意义(P<0.05)。试验组患者不良反应发生率(8.89%)与对照组(6.82%)比较,差异无统计学意义(P>0.05)。BMI亚组分析显示,肥胖患者(BMI≥23 kg/m^(2))Lequesne评分显著高于非肥胖者(6.89±2.51 vs 5.02±1.98,P=0.020),且并发症发生率更高(12.12%vs 0%,P=0.313)。结论UKA可有效改善内侧间室重度KOA老年患者膝骨关节炎症状,改善下肢内侧间室应力负荷,安全性良好。Objective To observe the postoperative limb load and adverse prognosis in elderly patients with severe medial compartment knee osteoarthritis(KOA)undergoing unicompartmental knee arthroplasty(UKA),providing reference for clinical practice.Methods A total of 89 elderly KOA patients treated at Puyang Traditional Chinese Medicine Hospital from June 2022 to June 2023 were selected as study subjects.They were divided into a control group(44 cases)and an experimental group(45 cases)using a random number table method.The control group underwent total knee arthroplasty,while the experimental group underwent UKA.The Lequesne index scores(Chinese version),knee medial compartment stress load,Berg Balance Scale(BBS)scores,and incidence of complications were compared between the two groups,and the impact of BMI subgroups on overall complications was analyzed.Results Postoperatively,both groups showed a decrease in the Lequesne index scores,with the experimental group scoring lower than the control group,a statistically significant difference(P<0.05).Both groups experienced an increase in knee adduction moment(KAM)and knee flexion moment(KFM)levels postoperatively,with the experimental group being higher than the control group,a statistically significant difference(P<0.05).BBS scores increased in both groups postoperatively,with the experimental group scoring higher than the control group,a statistically significant difference(P<0.05).The incidence of adverse reactions was 8.89%in the experimental group compared to 6.82%in the control group,with no statistically significant difference(P>0.05).BMI subgroup analysis showed that obese patients(BMI≥23 kg/m²)had significantly higher Lequesne scores than non-obese patients(6.89±2.51 vs 5.02±1.98,P=0.020)and a higher incidence of complications(12.12%vs 0%,P=0.313).Conclusion UKA can effectively improve symptoms of severe medial compartment KOA in elderly patients,improve medial compartment stress load in the lower limbs,and has good safety.

关 键 词:重度骨关节炎 膝关节内侧间室 人工单髁关节置换术 下肢应力负荷 不良预后 

分 类 号:R684.3[医药卫生—骨科学]

 

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