| 杜保平,王文革,李仕臣,等.固定平台单髁置换术在治疗中重度膝骨关节炎内侧间室病变中的临床疗效[J].安徽医药,2024,28(2):339-343. |
| 固定平台单髁置换术在治疗中重度膝骨关节炎内侧间室病变中的临床疗效 |
| Evaluation and analysis of the effect of fixed platform unicondylar replacement in the treatment of moderate to severe knee osteoarthritis with medial compartment lesions |
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| DOI：10.3969/j.issn.1009-6469.2024.02.028 |
| 中文关键词: 骨关节炎，膝 关节成形术，置换，膝 内侧间室病变 固定平台单髁置换术 全膝关节置换术 |
| 英文关键词: Osteoarthritis,knee Arthroplasty,replacement,knee Medial compartment disease Fixed platform unicompartmental knee arthroplasty Total knee arthroplasty |
| 基金项目:山西省卫生计生委科研课题( 2018154) |
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| 中文摘要: |
| 目的比较重度膝骨关节炎(KOA)内侧间室病变中固定平台单髁置换术( UKA)与全膝关节置换术( TKA)的临床疗效。方法选取 2019年 3月至 2021年 3月于临汾市中心医院就诊的膝骨关节炎内翻畸形病人 121例，根据手术方式的不同分为 UKA组( n=61，固定平台 UKA治疗)和 TKA组( n=60，不保留后交叉韧带 TKA治疗)。比较两组手术一般情况、早期恢复速度；比较两组术前、术后疼痛情况、膝关节功能及膝关节活动度( ROM)；比较两组不良事件发生情况。结果 TKA组手术时间、切口长度、术中失血量、下床时间、可步行 1 min时间、可屈曲 90°时间、住院时间分别为( 50.25±4.14)min、(10.32±2.31)cm、(142.17±18.34)mL、(1.87±0.30)d、(4.95±0.33)d、(8.14±0.89)d、(10.24±2.76)d，UKA组分别为( 29.37±3.25)min、(7.43±0.78)cm、(63.78±5.28)mL、(1.12±0.25)d、(2.96±0.47)d、(6.26±0.78)d、(7.76±0.62)d。与 TKA组比较， UKA组手术时间、切口长度、下床时间、可步行 1 min时间、可屈曲 90°时间、住院时间均显著缩短，术中失血量均显著减少( P<0.05)。术后 1、7、14 d，与 TKA组(4.27±0.32)分、(3.09±0.23)分、(2.26±0.17)分比较， UKA组疼痛数字评分量表( NRS)评分( 3.36±0.27)分、(2.47±0.24)分、(1.57±0.18)分均显著降低(P<0.05)。术后 3、6个月，与 TKA组比较， UKA组 Lysholm评分均显著升高， ROM均显著增加( P<0.05)。两组切口均达到 Ⅰ期愈合标准，无 UKA转行 TKA病人，出院时均具有较好的状态。随访期间，两组病人均无切口感染、严重疼痛、假体脱位或松动下沉、翻修等不良事件。结论重度 KOA内侧间室病变中 UKA与 TKA均可获取较好的中期疗效，但 UKA创伤小、术中出血量少、疼痛轻，且恢复速度快。 |
| 英文摘要: |
| Objective To compare the clinical efficacy of fixed platform unicondylar arthroplasty (UKA) and total knee arthroplasty(TKA) in severe knee osteoarthritis (KOA) with medial compartment disease.Methods A total of 121 patients with knee osteoarthritisvarus deformity who visited Linfen Central Hospital from March 2019 to March 2021 were randomly selected and divided into UKAgroup (n=61, fixed platform UKA treatment) and TKA group (n=60, posterior cruciate ligament-preserving TKA treatment) according todifferent surgical methods. The general condition and early recovery speed were compared between the two groups. The preoperativeand postoperative pain, knee function and range of motion (ROM) of the knee joint were compared between the two groups. The inci.dence of adverse events was comparedbetween the two groups.Results The operation time, incision length, intraoperative blood loss,time to get out of bed, time to walk for 1 min, time to 90° flexion, and hospital stay in TKA group were (50.25±4.14) min, (10.32±2.31)cm, (142.17±18.34) mL, (1.87±0.30) d, (4.95±0.33) d, (8.14±0.89) d, (10.24±2.76) d, while those of the UKA group were (29.37±3.25)min, (7.43±0.78) cm, (63.78±5.28) mL, (1.12±0.25) d, (2.96±0.47) d, (6.26±0.78) d, (7.76±0.62) d. Compared with the TKA group, theoperation time, incision length, time to get out of bed, time to walk for 1 min, time to 90° flexion, and hospital stay in the UKA groupwere significantly shortened, of which the intraoperative blood loss was significantly reduced(P<0.05). The NRS scores of UKA group(3.36±0.27) score, (2.47±0.24) score and (1.57±0.18) score were significantly lower than those of TKA group (4.27±0.32) score, (3.09±0.23) score, and (2.26±0.17) score at 1, 7, and 14 days after operation (P<0.05). Compared with the TKA group, the Lysholm score andthe ROMof the UKA group were significantly increased at 3 and 6 months after operation (P<0.05). The incisions in both groupsreached the standard of primary healing, and no patients with UKA converted to TKA were discharged from hospital in good condition.During the follow-up period, there were no adverse events such as incision infection, severe pain, prosthesis dislocation or looseningand subsidence, and revision in both groups.Conclusion Both UKA and TKA can achieve good mid-term efficacy in severe KOA me.dial compartment disease, but UKA has less trauma, less intraoperative blood loss, less pain, and faster recovery. |
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