膝关节单髁置换术与全膝关节表面置换术治疗单间室骨性关节炎的初期疗效的对比分析

发布时间：2018-08-28 10:27

【摘要】：目的：研究本地区膝关节单髁置换术（UKA）与膝关节表面置换术（TKA）治疗累及单侧间室的骨性关节炎的初期疗效并作出统计学分析。方法：从我院自开展UKA手术开始，2013年1月-2014年10月明确诊断为膝关节骨性关节炎且仅累及单侧间室的患者中筛选，从符合条件的患者中选择20名患者作为研究对象，其中男性5例，女性15例，有6例患者病患在右膝，其余14例在左膝。将选取的研究对象随机两组，每组各10例。分别给予TKA与UKA治疗，对比两组患者疼痛缓解的情况，，手术前后HSS评分的变化，术后1周自主达到的屈曲角度及术后3d血红蛋白（Hb）下降量。随访期定为5-14个月。UKA治疗手术适应症为：①局限于膝关节内侧间室退行性关节病变；②具有完整的前交叉韧带；③可矫正的内翻畸形。结果：两组患者手术顺利，均未出现严重并发症。UKA组患者无术中转TKA手术者。术后两组患者膝关节疼痛程度都明显减轻，且两者比较无显著性差异。两组患者经治疗1周后膝关节屈曲角度均显著增大，但两组相比较有明显差异（P0.05）。与TKA组比较，UKA组术中出血少（P0.05）. 结论：治疗累及单侧间室的膝关节骨性关节炎，两种方法都能够有效缓解患者痛苦，针对膝关节单间室重度OA，在手术选择，UKA具有微创，损伤小，术后恢复快及更贴近正常生理情况等优点。
[Abstract]:Objective: to study the initial curative effect of (UKA) and (TKA) in the treatment of osteoarthritis with unilateral interventricular involvement. Methods: from January 2013 to October 2014, 20 patients with osteoarthritis of the knee were selected from the patients who were diagnosed as osteoarthritis of the knee and only involved in the unilateral compartment from the UKA operation in our hospital, and 20 patients were selected from the eligible patients as the study subjects. There were 5 males and 15 females with 6 patients on the right knee and 14 on the left knee. The subjects were randomly divided into two groups, 10 cases in each group. The patients were treated with TKA and UKA respectively. The pain relief, the changes of HSS score before and after operation, the flexion angle reached 1 week after operation and the decrease of hemoglobin (Hb) on the 3rd day after operation were compared between the two groups. The following up period was 5-14 months. The operative indication of UKA was: 1 was confined to the medial interventricular degenerative joint lesions of the knee and 2 had complete anterior cruciate ligament (ACL) 3 varus deformity. Results: the operation was successful in both groups. There were no severe complications in both groups. There was no intraoperative conversion to TKA in the UKA group. There was no significant difference in knee pain between the two groups. After 1 week of treatment, the knee flexion angle of the two groups increased significantly, but there was significant difference between the two groups (P0.05). Compared with TKA group, intraoperative bleeding was less in TKA group (P0.05). Conclusion: in treating knee osteoarthritis involving unilateral compartment, both methods can effectively relieve the pain of knee joint. The severe OA, of single compartment of knee joint is minimally invasive and minimally injuried. It has the advantages of quick recovery and closer to normal physiological condition after operation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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