膝关节单髁置换术与全膝关节置换术治疗膝关节内侧间室骨关节炎初期疗效对比

发布时间：2019-05-28 19:36

【摘要】：背景:膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)是治疗膝关节内侧间室骨关节炎的有效方法,但对于其初期疗效尚存在很大争议。目的目的:探讨UKA和全膝关节置换术(total knee arthroplasty,TKA)在治疗膝关节内侧间室骨关节炎的初期临床疗效,为临床手术方案选择提供参考依据。方法方法:回顾性分析2011年1月至2016年1月采用OxfordⅢ单髁系统治疗膝关节内侧间室骨关节炎患者45例,男21例,女24例,年龄52~78岁,平均(64.5±7.5)岁。并随机选取同期行TKA并得到随访的膝关节内侧间室骨关节炎患者45例,男18例,女27例;年龄52~75岁,平均(63.2±10.0)岁。记录两组患者的手术时间、术中出血量、输血率、术后引流量、住院时间,以及术前、术后7 d、术后6个月、末次随访时的膝关节美国特种外科医院(HSS)评分、疼痛视觉模拟(VAS)评分、膝关节活动度(ROM)。结果结果:全部获得随访,随访时间为6~50个月,平均(25.5±10.5)个月。均无假体松动下沉、脱位及对侧间室病变。两组患者手术情况及术后恢复功能比较,UKA组在手术时间、术中出血量、输血率、术后引流量、住院时间、术后7 d及6个月随访时HSS评分、VAS评分、ROM明显优于TKA组(P0.05);末次随访时,两组患者的HSS评分、VAS评分及ROM比较无统计学差异(P0.05)。结论结论:UKA治疗膝关节内侧间室骨关节炎的初期疗效优于TKA,且具有手术时间短、术中出血量少、术后恢复快等优点。
[Abstract]:Background: single condyle replacement of knee joint (unicompartmental knee arthroplasty,UKA) is an effective method for the treatment of medial interventricular osteoarthritis of knee joint, but the initial curative effect is still controversial. Objective: to investigate the initial clinical effect of UKA and total knee arthroplasty (total knee arthroplasty,TKA) in the treatment of medial interventricular osteoarthritis of knee joint, and to provide reference for the selection of clinical surgical scheme. Methods: from January 2011 to January 2016, 45 patients (21 males and 24 females, with an average age of (64.5 卤7.5) years) with medial interventricular osteoarthritis of knee joint were treated with Oxford III unicondylar system. 45 patients with medial interventricular osteoarthritis of knee joint, 18 males and 27 females, with an average age of (63.2 卤10.0) years, were randomly selected and followed up with TKA at the same time. The operation time, intraoperative blood loss, transfusion rate, postoperative drainage, hospitalization time, and (HSS) score of American special surgical hospital of knee joint before operation, 7 days after operation, 6 months after operation and at the last follow-up were recorded. Pain visual simulation (VAS) score, knee motion (ROM). Results: all patients were followed up for 6 脳 50 months, with an average of (25.5 卤10.5) months. There were no loosening and subsidence, dislocation and contralateral interchamber lesions. The operation time, intraoperative bleeding volume, blood transfusion rate, postoperative drainage rate, hospitalization time, HSS score and VAS score were compared between the two groups in operation time, intraoperative bleeding volume, blood transfusion rate, postoperative drainage volume, hospitalization time, HSS score and VAS score at 7 days and 6 months after operation. ROM was significantly better than TKA group (P 0.05). At the last follow-up, there was no significant difference in HSS score, VAS score and ROM between the two groups (P 0.05). Conclusion: the initial curative effect of UKA in the treatment of medial interventricular osteoarthritis of knee joint is better than that of TKA, and has the advantages of short operation time, less intraoperative bleeding and faster postoperative recovery.
【作者单位】：安徽医科大学第四附属医院骨科;
【分类号】：R687.4

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