胃后动、静脉的观察及其临床意义

观察了50具尸体的胃后动、静脉,其结果:一、胃后动脉出现率为72％,外径平均成人为2.2mm,儿童为0.8mm。胃后静脉出现率为70％,外径平均成人为1.6mm,儿童为0.8mm。二、胃后动脉距腹腔动脉平均为4.4cm,胃后动脉平均长3.2mc。胃后静脉汇入脾静脉或其上极支处距门静脉平均为5.2cm,胃后静脉平均长3.2cm。三、胃后动脉基本上有胃后静脉伴行,静脉以单支者为多见。     

脊髓下段后索动脉供应的应用解剖

目的 为脊髓下段后索切开行周围神经游离移植或转位桥接术提供解剖学资料。方法 观测15具(30侧)成人尸体标本T_(10)-L_1脊柱平面的脊髓后动脉及动脉吻合的位置、管径及出现率。结果 脊髓后动脉在脊髓后外侧沟与后正中沟之间,呈连续或断续分布,出现率100％,平均管径为0.46mm,距后正中沟距离平均2.2mm,距后外侧沟距离平均为0.54mm。两侧间无显著差异。脊髓后动脉间吻合动脉的出现率为33％,平均管径0.40mm。结论 脊髓后动脉是脊髓下段后索区域的主要供血来源。脊髓后索纵行切口选择在离后正中沟1.5mm处损伤血管的可能性较小。     

千万别轻视卒中后的抑郁

李大爷今年60多岁,平时除了血压稍高之外,没什么大病。本来日子过得挺顺心的,可前不久他犯了一次脑梗,偏瘫了。 出院后,经过家人的全心照料,李大爷慢慢能走路了,可他却变得不爱出门了,觉得走路不利落让人看见会被笑话。     

国人胃后动脉及其临床意义

本文在查阅了资料后就胃后动脉以下几方面进行综述。1.胃后动脉的起源、出现率、类型;起源于脾动脉者最多,占78％;出现率为62％～88％;绝大部分为一支类型,占75.44～92％。2.外径、长度、毗邻;外径在1.53～3mm之间;长度为2.2～8.1cm;90％的与胃后静脉伴行。3.行径、供血区:在脾动脉上缘发出后,在网膜囊后壁腹膜外向上方走行,经胃膈韧带内最后进入贲门侧的胃底部,并供应该区的血液。     

胃后动、静脉的应用解剖学

用100具尸体(成尸66、童尸34),观测了胃后血管。(1)胃后动脉 出现率88.0%,1支者占89.8%,2支者占10.2%.起自脾动脉中1/3段者居多(78.6%),有94.9%的胃后动脉穿入胃底部后壁。该动脉平均长3.5cm,外径1.5mm.(2)胃后静脉 出现率87.0%,1支者占92.0%.注入脾静脉中1/3段者较多(76.6%),该静脉平均长4.4cm,外径1.7mm。     

个体化手术入路治疗后侧Pilon骨折14例近期临床疗效评价

目的探讨个体化手术入路治疗后侧Pilon骨折的临床疗效。方法 2012年6月~2014年11月,个体化手术入路治疗后侧Pilon骨折14例。男性9例,女性5例;年龄28~67岁,平均47岁。右侧6例,左侧8例;致伤原因:摔伤10例,交通事故伤4例;合并同侧腓骨下端骨折12例,合并同侧内踝骨折8例,合并同侧踝关节半脱位4例;所有患者均为闭合性骨折。受伤至手术时间为2~8天,平均4.5天;5例经后外侧入路,2例经后内侧入路,7例经后外侧联合后内侧入路切开复位内固定。术后定期随访,观察骨折愈合情况;末次随访时,采用Kellgren创伤性关节炎评级和美国足踝外科学会(AOFAS)踝与后足功能评分系统对术后疗效进行评估。结果1例患者后外侧切口出现部分坏死感染,经保守治疗后愈合,其余患者切口均获Ⅰ期愈合;1例患者有胫后神经麻痹症状,口服弥可保后症状消失;14例患者中12例获得随访,随访时间12~24个月,平均16个月。骨折均愈合,愈合时间为3~6月,平均4个月。随访期间,无断钉,内固定松动等并发症发生;末次随访时,依据Kellgren创伤性关节炎评级:0级10例,Ⅰ级1例,Ⅱ级1例;依据AOFAS评分:优8例,良3例,可1例,优良率91.7%。结论个体化手术入路能充分暴露骨折块,为踝关节的解剖复位提供良好的基础,近期临床疗效满意。     

两种镇痛方式对妇科术后病人镇痛效果的比较

目的观察硬膜外吗啡术后镇痛与静脉曲马多复合芬太尼术后镇痛这两种镇痛方式对妇科术后病人镇痛效果比较。方法将80例心功能（ASA）Ⅰ-Ⅱ级的妇科手术病人随机分成A、B组，每组各40例。A组病人采用硬膜外持续微量注射镇痛泵（PCEA）泵入吗啡术后镇痛，B组病人采用静脉自控微量注射镇痛泵（PCIA）泵入曲马多复合芬太尼术后镇痛。观察并记录病人术后的疼痛情况、头痛头晕、恶心呕吐、术后排气、拔除尿管后的第一次排尿时间以及意外脱管等。结果两组间视觉模拟评分（VAS）评分比较、头痛头晕、恶心呕吐总发生率、术后排气均无统计学意义（P〉0．05）。A组拔除尿管后的第一次排尿时间较B组短（P〈0．05）。结论静脉联合应用曲马多和芬太尼镇痛安全有效，有利于术后病人充分配合治疗和早期活动，促进早期康复，值得临床推广应用。     

在新型成年大鼠纵切脊髓片上骶髓后连合核神经元的盲膜片钳全细胞记录(英文)

本文介绍了一种新型的成年大鼠（5－8周龄）纵切脊髓片模型．此模型与传统的横切脊髓片的不同之处是可带有多条长达10mm的后根．在体视显微镜下骶髓后连合该（DCN）为一条透明的灰质带，极易与后角其它部位区分，因此最适合于对DCN神经元的研究．应用盲膜片钳全细胞记录法，在此模型上研究了DCN神经元自发的和后根刺激诱发的兴奋性突触后电位（EPSPs）．自发的和后根刺激诱发的快EPSPs主要由非NMDA谷氨酸受体介导；后根刺激诱发的促EPSPs由NMDA受体（或／和）P物质受体介导．此模型可用于初级传入信息在DCN内的突触传递机理以及相邻阶段间初级传入信息的相互作用的研究。     

睫状神经节的形态观测及其临床意义

对３７侧成人睫状神经节的位置，形态，大小和各神经根来源等进行了解剖观测。测量从眶下缘中外１／３交点型神经节的直线距离为４４．７８±３．４４ｍｍ，针与眼耳平面，矢状面，冠状面的夹角各为２６．４±６．２°，２３．２±６．１°，６６．１±７．５°，提出球后麻醉进针深度可增至３０－４０ｍｍ。最后讨论了针刺“球后”穴的解剖学基础。     

Bracing and taping techniques and patellofemoral pain syndrome

Reference/Citation:

D''hondt NE, Struijs PA, Kerkhoffs GM, et al. Orthotic devices for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2002;(2):CD002267.

Clinical Question:

Is there an effective bracing or taping technique for treating patellofemoral pain?

Data Sources:

The authors searched the Cochrane Musculoskeletal Injuries Group specialized register (December 2001), the Cochrane Controlled Trials Register (2000, issue 2), MEDLINE (January 1966 to March 2000), EMBASE (January 1988 to March 2000), CINAHL (January 1982 to March 2000), and PEDro (up to March 2000) without language limitations. They also contacted relevant orthotic companies and searched the included reference lists of the retrieved articles. The search terms for MEDLINE were anterior knee pain, arthralgia, knee joint, patella, and patellofemoral pain. The search terms for EMBASE were brace, chondropathy, dynamic splint, knee, orthosis, orthotics, patella, patella chondromalacia, patellofemoral joint, randomized control trial, and strap. The search terms for CINAHL were anterior knee pain, brace, orthot, orthos, randomi, strap, tape, patell, and patellofemoral. In PEDro, the subsequent composite of search terms was therapy: manipulation, massage, mobilization, orthoses, splinting, stretching, strength training, taping; subdiscipline: musculoskeletal, orthopaedics, sports; method: clinical trial; problem: muscle weakness, pain, reduced joint compliance; body part: foot or ankle, lower leg or knee.

Study Selection:

All randomized and quasi-randomized trials comparing the effectiveness of knee or foot orthotics for treatment of patellofemoral pain syndrome were included. Any trials that described the use of orthotic devices in conjunction with operative treatment were excluded from this review. Using these inclusion criteria, 2 reviewers independently assessed the potentially eligible studies and resolved any disagreements through conversation and negotiation by a third reviewer. Although the authors mentioned that the review''s purpose was to assess knee and foot orthoses, none of the included studies assessed foot orthoses. Therefore, all trials that examined foot orthotics were excluded.

Data Extraction:

Using a preset extraction form, 2 reviewers independently entered data into a review manager software program (RevMan 2000; The Cochrane Collaboration, Oxford, United Kingdom). This program was produced by the Cochrane Collaboration to support systematic reviews. Any further information needed regarding methods and data was requested from the authors. Because of heterogeneity of the study population, interventions, and follow-up periods, statistical pooling was not conducted. In place of statistical pooling, the strength of scientific evidence was graded based on a scale of A through D, with A being the strongest evidence-based research and D being the weakest evidence-based research.

Main Results:

The search strategy identified 15 trials, of which only 5 trials met all the inclusion criteria and had enough data to be considered for pooling. The 5 trials involved 362 participants who were assessed for pain, functional improvement, isokinetic muscular strength, motivation, subjective success, worst pain, usual pain, subjective clinical pain, and patellofemoral congruence angle. Of the 5 studies included in the review, only the following statistically significant differences were found. The Protonics orthosis significantly decreased pain and improved function based on the Kujala score versus no treatment. A home exercise program with McConnell taping and biofeedback decreased pain and improved function based on the Functional Index Questionnaire versus home exercise and monitored therapy. In addition, the Protonics orthosis versus no treatment resulted in a patellofemoral congruence angle change; McConnell taping versus Couman bandage improved satisfaction with applied therapy and isokinetic muscle strength at 300°/s of knee flexion. No other findings included in the review studies were statistically significant. The included studies were inadequate in their methodologic quality and incomplete in their research-based evidence, which was obtained by their investigators.

Conclusions:

According to the systematic review by D''hondt et al, the strength of retrieved research-based evidence of effectiveness of orthotic devices in the treatment of patellofemoral pain syndrome was graded C. This grade was appropriate because all trials had low-quality methodologic evidence to support or reject the effectiveness of orthotics and taping techniques in reducing pain. Although very little scientific evidence is available regarding the use of orthotics and taping techniques, D''hondt et al identified trends in orthotics and taping techniques that should be considered in clinical practice. A comprehensive exercise and stretching program with tape application was more effective in decreasing worst pain and usual pain and increasing functional improvement. This finding indicates that patellofemoral pain syndrome is best treated by using more than 1 intervention. In addition, no difference was apparent in pain outcomes between McConnell taping technique and Couman bandage: neither technique resolved pain. The Protonics orthosis actively affected patellar tracking by reducing internal rotation of the femur and compression on the lateral aspect of the patella. As a result, the Protonics orthosis reduced pain compared with no treatment. In contrast, the Couman bandage is used only to guide the patellar tracking pattern and massage the structures around the patella during motion. Yet a home exercise program with the addition of a stretching program and McConnell taping decreased pain and increased function, which may suggest that a combination of treatment approaches is needed to effectively treat the condition, as found in previous studies.     

Influence of cartilage and menisci on the sagittal slope of the tibial plateaus

We analyzed the magnetic resonance studies of the knee in 80 subjects, 45 men and 35 women with a mean age of 38.9 years, who showed no pathological condition of the joint. Using an imaging visualization software, the sagittal longitudinal axis of the tibia was identified. The angle between this axis and a line tangent to the bone profile of the tibial plateau (bone slope) and to the superior border of the menisci (meniscal slope) were calculated. Thickness of anterior and posterior portion of menisci and underlying cartilage were also measured. The bone slope averaged 8° and 7.7° on the medial and lateral sides, respectively. The mean meniscal slope was 4.1° and 3.3° on the medial and lateral sides, respectively, with a significant difference compared with the bone slope. Menisci and underlying cartilage were significantly thicker in their posterior than their anterior portion (7.6 and 5.2 mm, respectively, in the medial compartment; 8.6 and 5.2 mm, respectively, in the lateral compartment). The presence of cartilage and menisci implies a significant decrease in the posterior tibial slope. In the lateral compartment, the greater the bone slope, the larger the difference between bone and meniscal slope, which means that a marked posterior tilt of the lateral tibial plateau is decreased by the cartilage and meniscus. These findings should be taken into account in planning surgical procedures which affect the slope of the articular tibial surface. Clin. Anat. 26:883–892, 2013. © 2012 Wiley Periodicals, Inc.     

牛津双柱单髁置换术与全膝关节置换术治疗膝内侧骨关节炎的近中期疗效对比

目的 探讨牛津双柱单髁置换术(UKA)与全膝关节置换术(TKA)治疗膝内侧骨关节炎的近中期疗效。方法 回顾性队列研究。纳入2016年10月—2019年11月安徽医科大学第四附属医院50例膝关节内侧间室骨关节炎患者的临床资料。其中,采用牛津双柱UKA治疗的25例(25膝)为UKA 组,男7例、女18例,年龄54~81岁;采用TKA治疗的25例(25膝)为TKA组,男6例、女19例,年龄47~84岁。比较两组患者的手术时间、术中出血量、术后膝关节主动屈曲到90°时所需的时间、住院时间、术后人工关节遗忘指数,以及两组患者术前及术后1、6、12个月的膝关节活动度(ROM)、疼痛视觉模拟评分法(VAS)、美国特种外科医院(HSS)评分和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分,并据HSS评分评价膝关节功能。结果 两组患者性别、年龄、体质量指数等基线资料比较,差异均无统计学意义(P值均＞0.05)。所有患者均获得随访,UKA组平均随访时间22.6个月(13~43个月),TKA组平均随访时间22.4个月(12~36个月),两组患者均取得良好的疗效,且无患者出现感染、假体松动及翻修。UKA组在手术时间、术中出血量、住院时间、术后膝关节主动屈曲到90°所需时间、人工关节遗忘指数上明显优于TKA组,差异均有统计学意义(P值均＜0.05)。UKA组术后1、6、12个月HSS评分分别为(77.84±1.07)、(86.20±1.58)、(90.08±1.61)分,WOMAC评分分别为(12.44±2.95)、(11.20±2.33)、(10.44±1.47)分,VAS评分分别为(2.80±0.71)、(2.20±0.41)、(1.48±0.59)分,ROM分别为109.56°±8.38°、115.12°±11.72°、116.60°±9.14°;TKA组1、6、12个月HSS评分分别为(72.56±1.16)、(81.80±2.12)、(85.64±2.38)分,WOMAC评分分别为(16.72±3.47)、(13.32±1.44)、(12.44±2.31)分,VAS评分分别为(3.32±0.80)、(2.80±0.65)、(2.48±0.51)分,ROM分别为102.80°±12.42°、108.40°±10.72°、110.20°±10.89°,两组术后HSS、WOMAC、VSA评分及ROM比较差异均有统计学意义(P值均＜0.05)。UKA组患者膝关节功能优良率为96%(24/25),TKA组优良率为88%(22/25),差异无统计学意义(χ²=0.262, P＞0.05)。结论 与TKA相比,采用牛津双柱UKA治疗膝关节内侧骨性关节炎,手术创伤小、术后恢复快,使患者获得更好的本体感觉和满意的膝关节功能。     

Ethnic-, gender-, and age-related differences in femorotibial angle, femoral antetorsion, and tibiofibular torsion: cross-sectional study among healthy Japanese and Australian Caucasians

The current study was conducted to examine ethnic, gender, and age-related differences in femorotibial angle (FTA), femoral antetorsion and tibiofibular torsion. Healthy Japanese (n = 120) and Australian Caucasian (n = 82) subjects were examined using a series of clinically reliable methods for measuring FTA and torsion of the lower limb. Subjects between 18-29 years of age were categorized as younger, 30-59 years as middle age, and 60 or more as older age. Three-way analysis of variance was utilized for data analysis. The Japanese subjects had significantly greater FTA (more varus) than the Australian subjects (P < 0.001). Femoral antetorsion in the Japanese subjects was significantly smaller in middle and older age groups than younger group (P < 0.05), but did not differ between the age groups in the Australian subjects. Further, tibiofibular torsion in female subjects was significantly greater in younger and middle age groups than the older age group (P < 0.01), but was not different between different age groups in males. The results suggest that healthy Japanese may have more genu varus alignment compared to the corresponding Australian population. Age-related ethnic and gender differences in femoral and tibiofibular torsion are worthy of further study.     

Motion of the anterior cruciate ligament during internal and external rotation at the knee: A cadaveric study

Despite advances in our understanding of anterior cruciate ligament (ACL) anatomy and function, the change in position of the ACL during tibial rotation is not well understood. The purpose of this study was to quantify and compare the movements of the anteromedial (AM) and posterolateral (PL) bundles of the ACL during 15° of medial and lateral rotation (with & without a shear force). Cadaveric knees (12 male/12 female) were dissected and mounted at 90° of knee flexion. Anthropometric features of the ACL and distal femur were recorded, and each bundle was marked at: femoral attachment (FA), midpoint of ligament (MP), and tibial attachment (TA). Digital images of ACL motion in the frontal plane were taken as the tibia was rotated about a fixed femur. Using digitizing software, the change in position of the markers was quantified. Measurements suggested the ACL pattern of motion was consistent between sexes, regardless of shear force. The greatest amount of movement of both the AM and PM bundles occurred at the TA marker. The FA marker moved more during medial rotation, and the MP and TA markers moved more with lateral rotation. The 20 lb‐shear force affected medial rotation most. This study is the first to quantify movement of the ACL during medial and lateral tibial rotation. Data should assist surgeons to select a graft position that is capable of replicating the rotational movement of the native ACL, and help improve three‐dimensional stability of the ACL reconstructed knee. Clin. Anat. 30:861–867, 2017. © 2017 Wiley Periodicals, Inc.     

Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau

The aim of this study was to address, in normal knees, the variability of posterior offset of femoral condyles and tibial slope, and the presence of any correlation between the two that might be needed to achieve an adequate joint motion in flexion. Magnetic resonance images of normal knees of 80 subjects, 45 males and 35 females, with a mean age of 38.9 years, were analysed. Measurements were performed by two independent observers using an imaging visualization software. The tibial slope averaged 8 and 7.7 °, on the medial and lateral sides, respectively (P = 0.2); the mean posterior offset of femoral condyles was 27.4 and 25.2 mm on the two sides, respectively (P = 0.0001). The variation coefficient of the condylar offset and tibial slope was 11.5 and 38%, respectively. In the medial compartment, a significant correlation was found between the femoral condylar offset and the tibial slope, while the same was not observed in the lateral compartment of the knee. Magnetic resonance imaging allows the assessment of tibial slope and femoral condylar offset in the medial and lateral side separately, taking into account any difference between the two compartments. The sagittal tibial slope exhibits a greater variability compared with the posterior offset of femoral condyles. The correlation found, in the medial compartment, between the tibial slope and femoral condylar offset suggests that the reconstitution of the proper morphology of the posterior part of the knee joint may be necessary to obtain a full range of motion in flexion after total knee replacement.     

Standing and Supine Hamstring Stretching Are Equally Effective

OBJECTIVE: To evaluate the relative effectiveness of standing and supine hamstring stretching in increasing hamstring flexibility as measured by increasing range of motion at the knee. DESIGN AND SETTING: The trial was randomized, and the setting was local academic physical therapy and physical therapist assistant programs. SUBJECTS: Twenty-nine healthy subjects who exhibited limited hamstring muscle flexibility bilaterally (22 women, 7 men, 25.9 +/- 6.13 years of age) volunteered to participate in this study. Subjects were randomly assigned a different stretch for each leg. Each leg was stretched 3 days per week for 3 weeks (3 x 30 seconds). Stretching sessions were supervised. MEASUREMENTS: We measured supine active knee extension. Measurements were taken before and after the 3-week stretching phase by the same investigator, who was blind to limb assignment. We calculated a 2-way mixed-design analysis of variance and Tukey Honestly Significant Difference post hoc tests to analyze data. An independent t test was performed to determine whether the change scores in the stretching groups differed by sex. RESULTS: Prestretching and poststretching measurements were significantly different for both the standing and supine stretch (<0.05). No significant difference (P > .05) in change score existed between the 2 stretches or between the sexes. CONCLUSIONS: The standing and supine hamstring stretches were comparably effective in improving flexibility.     

运动防治膝骨关节炎的关键因素及注意事项

文题释义： 运动疗法：是指利用器械、徒手或患者自身力量,通过某些运动方式(主动或被动运动等),使患者获得全身或局部运动功能、感觉功能恢复的训练方法。运动疗法主要采用“运动”这一机械性的物理因子对患者进行治疗,着重进行躯干、四肢的运动、感觉、平衡等功能的训练,包括：关节功能训练、肌力训练、有氧训练、平衡训练、易化训练、移乘训练、步行训练。 骨关节炎：为一种退行性病变,系由于增龄、肥胖、劳损、创伤、关节先天性异常、关节畸形等诸多因素引起的关节软骨退化损伤、关节边缘和软骨下骨反应性增生,又称骨关节病、退行性关节炎、老年性关节炎、肥大性关节炎等。临床表现为缓慢发展的关节疼痛、压痛、僵硬、关节肿胀、活动受限和关节畸形等。 背景：目前膝骨关节炎的治疗以缓解症状为主,真正根治较难。运动疗法是为了达到一些特定的治疗目标而专门设计和规范的体育活动计划,旨在恢复正常的肌肉骨骼功能和减少疾病或身体损伤引起的疼痛。有关运动疗法防治膝骨关节炎存在不同观点。 目的：探讨影响运动疗法防治膝骨关节炎疗效中的关键因素及注意事项,为运动疗法防治膝骨关节炎提供一定参考依据。 方法：应用计算机检索至2019年1月PubMed数据库、中国期刊全文数据库相关文章,英文检索词为：“exercise therapy,knee osteoarthritis,prevention and treatment”;中文检索词为：“运动疗法,膝骨关节炎,防治”。根据纳入排除标准,对检索到的关于运动疗法对膝骨关节炎作用的相关文献进行分析。 结果与结论：①运动疗法应尽早介入,早期需注意各部损伤时膝关节的角度问题,需逐渐增加活动度及强度,可以从非负重训练开始到后期训练可以负重;②运动疗法的强度应以中小强度为主,避免过度训练,特别是对于软骨磨损的患者。 ORCID: 0000-0002-1708-5181(宋校能) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

股骨内翻和胫骨内翻的运动学和足底压力分析

目的 探究胫骨侧和股骨侧来源的两种单侧膝骨关节炎膝内翻在步态分析中的运动学参数和足底压力差异,为不同类型膝内翻提供生物力学理论基础。方法 招募26名单侧膝骨关节炎型膝内翻患者,股骨侧和胫骨侧来源各13名受试者。利用Noraxon MyoMotion三维动作捕捉系统和Footscan平板式足底压力测试系统,测量受试者在自然行走状态下的步态,采集受试者步态的时空指标、下肢各关节运动学参数、足底压力,并进行两组间对比分析。结果 胫骨侧膝内翻的膝关节屈伸范围、髋关节外展峰值、髋关节内收外展活动范围、踝关节内旋峰值均大于股骨侧膝内翻,而膝关节屈曲峰值、髋关节内收峰值小于股骨侧膝内翻;与股骨侧膝内翻相比,胫骨侧膝内翻受试者第4、5跖骨足底受力时间、压力峰值都增加(P<0.05)。在第3跖骨区域中,股骨健侧肢体比胫骨畸形健侧肢体的冲量更大;而在足跟内侧区域,股骨健侧肢体的冲量更小(P<0.05)。结论 两种不同类型单侧膝内翻患者在运动学参数和足底压力方面存在一定差异。研究结果有助于正确认识膝内翻引起的异常步态,为不同类型膝内翻诊治、术后康复和肢体锻炼提供可靠参考。     

全膝关节置换术与单髁置换术治疗膝关节单间室骨关节炎的疗效比较

目的 比较全膝关节置换术(TKA)与膝关节单髁置换术(UKA)治疗膝关节单间室骨关节炎的临床疗效。方法 对2012年3月—2015年3月徐州医科大学附属医院骨科88例行TKA或UKA治疗单间室骨关节炎并获得随访患者的临床资料进行回顾性分析,依据不同手术方法分为TKA组48例(48膝)和UKA组40例(40膝)。采用美国特种外科医院(HSS)膝关节评分,评价疗效。比较两组患者手术时间、术中出血量、术后引流量,术后第1天、3天、1周血红蛋白水平和术后第3天血红蛋白较术前的下降量,以及末次随访时关节活动度和疗效。结果 两组患者手术顺利,88例患者获随访6~36个月,平均20.25个月。TKA组手术时间(85.77±7.61)min多于UKA组的(80.50±6.82)min,术中出血量(103.54±17.68)mL多于UKA组的(74.75±11.82)mL,术后引流量(420.21±68.80)mL多于UKA组的(241.75±53.05)mL,差异均有统计学意义(t=3.389、t'=8.787、t'=13.411,P值均＜0.01)。两组术前血红蛋白水平差异无统计学意义(P＞0.05);TKA组术后第1天、3天、1周血红蛋白均低于UKA组,术后第3天血红蛋白较术前的下降量高于UKA组,差异均有统计学意义(P值均＜0.05)。UKA组术后膝关节屈曲至90°所需时间为(7.33±3.02)d,短于TKA组的(12.63±3.10)d(t=8.086,P＜0.01);末次随访UKA组患者膝关节屈曲角度为116.98°±13.71°,大于TKA组的125.13°±15.95°(t=2.576,P＜0.01)。TKA组和UKA组HSS评分优、良、可、差者分别为25、19、3、1例和23、15、2、0例,其优良率分别为91.67%(44/48)和95.00%(38/40),差异无统计学意义(Z=0.603,P＞0.05)。两组患者中仅TKA组发生深静脉血栓1例,经介入治疗后痊愈;其余患者无手术并发症发生。结论 UKA与TKA治疗膝关节单间室骨关节炎均能获得满意的临床疗效,但UKA具有出血少、手术时间短、功能恢复快等优点。