固定平台型单髁置换术与全膝置换治疗内侧间室膝骨关节炎的早期疗效对比

目的 比较固定平台型膝关节单髁置换术(UKA)与保留后交叉韧带型全膝关节置换术(TKA)治疗内侧间室膝骨关节炎的早期疗效.方法 选取2016年1月至2020年5月安徽中医药大学第一附属医院收治的93例膝关节内侧关节炎患者作为研究对象,采用随机数字表法,分为A组(n=41)与B组(n=52).A组患者行固定平台型UKA,B组患者行保留后交叉韧带型TKA.比较两组患者各围术期指标、静息时疼痛视觉模拟(VAS)评分、国特种外科医院(HSS)膝关节评分及屈、伸膝情况的差异.结果 A组患者手术时间(48.63±10.23)min、手术切口长度(7.63±2.42)cm、术中出血量(53.62±8.30)mL、术后引流量(80.80±10.68)mL,均低于B组,差异有统计学意义(P<0.05).两组患者术前静息时VAS评分和膝关节HSS评分差异无统计学意义(P>0.05),A组患者术后第3、7、14天静息时VAS评分均低于B组,术后1周、1个月、3个月、6个月膝关节HSS评分均高于B组,差异均有统计学意义(P<0.05).A组患者术后下地负重步行达1 min时间(3.63±1.51)d、屈曲90°时间(6.72±1.65)d、最大伸膝度数(1.43±0.13)°、最大屈膝度数(110.52±9.67)°,均优于B组,差异均有统计学意义(P<0.05).结论 固定平台型UKA和保留后交叉韧带型TKA均能有效治疗膝关节内侧骨关节炎,但固定平台型UKA患者早期术后体验更佳.

Comparison of early curative effect between unicompartmental and total knee arthroplasty for medial compartment knee osteoarthritis

Objective To compare the early postoperative clinical experience of patients with medial compartment osteoarthritis of the knee who underwent fixed bearing -type unicompartmental knee arthroplasty and posterior cruciate ligament retaining -type total knee arthroplasty. Methods From January 2016 to May 2020, 93 cases of medial knee arthritis in the First Affiliated Hospital of Anhui University of Chinese Medicine were selected as the research objects and were divided into group A with 41 cases and group B with 52 cases by number random table method. Group A underwent fixed-bearing UKA, and group B underwent posterior cruciate ligament retaining type TKA. The perioperative indicators of the two groups were compared, such as the visual analogue of pain (VAS) score at rest, the knee joint score of the State Hospital of Special Surgery(HSS), and the knee flexion and extension. Results The operation time of group A was (48.63±10.23) min, the surgical incision length was (7.63±2.42) cm, the intraoperative blood loss was (53.62±8.30) mL, the postoperative drainage volume was (80.80±10.68) mL, which were lower than those of group B (P<0.05). There was no significant difference in VAS score and knee HSS score at rest between the two groups before surgery (P>0.05). The VAS score at rest 3 d, 7 d and 14 d after operation in group A was lower than that of group B (P<0.05), group A Knee HSS scores were higher than those of group B 1 week, 1 month, 3 months, and 6 months after operation (P<0.05). After operation, the patients in group A walked down the ground with weight for 1 min, (3.63±1.51) d, flexion time was (6.72±1.65)d, the maximum knee extension was (1.43±0.13)°, and the maximum knee flexion was (110.52±9.67)°, which were better than those of group B(P<0.05). Conclusions Both fixed-bearing UKA and posterior cruciate ligament retaining type TKA can effectively treat medial knee osteoarthritis, but the early postoperative experience of fixed-bearing UKA surgery is better.