单髁与全膝置换治疗老年单间室骨关节炎比较

发布时间：2018-11-07 14:00

【摘要】：[目的]比较单髁置换(UKA)与全膝置换(TKA)治疗老年膝关节单间室骨关节炎的近期临床疗效。[方法]回顾性分析2008年3月~2010年3月本院收治膝关节单间室骨关节炎患者43例,20例接受UKA治疗,23例接受TKA治疗。对比两组患者术前及末次随访膝关节屈曲活动度(ROM)、膝关节学会评分(KSS)、视觉模拟量表评分(VAS)及术中出血量和术后并发症。[结果]术中平均出血量UKA组(193.00±41.81)ml,TKA组(347.83±93.52)ml(P0.05),TKA组术后5例患者输血,UKA组术后无患者输血(P0.05)。UKA组术后屈膝到90°所用时间为(3.15±0.75)d,TKA组为(5.83±0.72)d(P0.05)。术后早期无感染、深静脉血栓发生。患者均获得2年以上随访(平均26.5个月),UKA组术前与末次随访ROM、KSS评分和VAS评分对比,差异有统计学意义(P0.001),TKA组差异也有统计学意义(P0.001)。末次随访时UKA组与TKA组间ROM、KSS评分和VAS评分对比,差异无统计学意义(P0.05)。患者随访期间无假体松动、关节翻修等严重并发症出现。[结论]对于膝关节单间室骨关节炎患者,在严格掌握手术适应证的前提下,UKA与TKA均能显著改善膝关节功能,近期疗效无显著差异。UKA具有创伤小、出血少、恢复快、术后早期膝关节活动度良好等优点,但是长期效果还有待研究。
[Abstract]:[objective] to compare the short-term clinical effect of single-condylar replacement (UKA) and total knee replacement (TKA) in the treatment of senile knee osteoarthritis. [methods] from March 2008 to March 2010, 43 cases of knee osteoarthritis were treated in our hospital, 20 cases were treated with UKA and 23 cases were treated with TKA. The knee flexion and range of motion (ROM), (KSS), visual analogue scale (VAS), intraoperative blood loss and postoperative complications were compared between the two groups. [results] the mean intraoperative blood loss was (193.00 卤41.81) ml,TKA group (347.83 卤93.52) ml (, P0.05), TKA). There was no blood transfusion in UKA group (P0.05). UKA group, the time of knee flexion to 90 掳was (3.15 卤0.75) days, the time of TKA group was (5.83 卤0.72) d (, P0.05). There was no infection and deep venous thrombosis occurred early after operation. All the patients were followed up for more than 2 years (mean 26.5 months). The ROM,KSS score and VAS score of the), UKA group were compared with those of the last follow-up group. The difference was statistically significant (P0. 001), TKA group was also statistically significant (P0. 001). At the last follow-up, there was no significant difference in ROM,KSS score and VAS score between UKA group and TKA group (P0.05). There were no severe complications such as prosthesis loosening and joint revision during follow-up. [conclusion] for patients with knee joint osteoarthritis, both UKA and TKA can significantly improve knee joint function on the premise of strict indication of operation. There is no significant difference in short-term curative effect. UKA has the advantages of less trauma, less bleeding and faster recovery. The early postoperative knee motion is good, but the long-term effect remains to be studied.
【作者单位】：安徽医科大学空军临床学院;空军总医院;北京大学第三医院骨科;
【分类号】：R687.4

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