全膝关节置换术与单髁置换术治疗老年膝关节骨关节炎的疗效比较

目的 分析针对老年膝关节骨关节炎患者采用全膝关节置换术或者单髁置换术的治疗价值.方法 随机抽取2017年6月—2019年6月该院76例老年膝关节骨关节炎病例,并以其手术方案分组,观察组采取单髁置换术方案治疗,对照组采取全膝关节置换术治疗,对比两组的术后关节功能恢复、疼痛评分以及术后并发症情况等.结果 观察组术后直腿抬高...     

单髁置换术与全膝关节置换术治疗膝单间室骨关节炎患者的效果比较

目的：比较单髁置换术（UKA）与全膝关节置换术（TKA）治疗膝单间室骨关节炎（KOA）患者的效果。方法：选取88例膝单间室KOA患者为研究对象,采用随机数字表法分为对照组和观察组各44例。对照组实施全膝关节置换术（TKA）治疗,观察组实施UKA治疗,术后随访1年。比较两组围术期相关指标（手术时间、术中出血量）水平、住院时间、治疗前后最大屈膝角度、疼痛程度[视觉模拟评分法（VAS）]评分、膝关节功能[美国特种外科医院膝关节功能（HSS）]评分,以及并发症发生率。结果：观察组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义（P<0.05）;术后,两组最大屈膝角度均大于术前,且观察组大于对照组,差异有统计学意义（P<0.05）;术后,两组VAS评分均低于术前,HSS评分均高于术前,差异有统计学意义（P<0.05）,但组间VAS、HSS评分比较,差异均无统计学意义（P>0.05）;观察组并发症发生率为6.82%(3/44),低于对照组的25.00%(11/44),差异有统计学意义（P<0.05）。结论：UKA治疗膝单间室KOA患者可缩短手术时...     

单髁关节置换术与全膝关节置换术对内侧单间室膝骨关节炎患者围术期指标和膝关节功能和术后并发症的影响

目的:探讨单髁关节置换术(Unicompartmental knee arthroplasty, UKA)与全膝关节置换术(Total knee arthroplasty, TKA)对内侧单间室膝骨关节炎患者围术期指标和膝关节功能和术后并发症的影响。方法:回顾性分析2020年3月至2021年6月我院收治的内侧单间室膝骨关节炎患者104例的临床资料,根据手术方式分组,有51例患者行单髁置换术归为UKA组,53例行全膝关节置换术为TKA组,比较两组患者围手术期相关指标,评估并比较两组术前、术后6、12个月的膝关节活动度(Range of motion, ROM),美国特种外科医院膝关节(hospital for special surgery knee score, HSS)评分,比较两种手术方法治疗前后下肢力线矫正情况、术后出现并发症的情况。结果:与TKA组相比,UKA组手术时间、自主屈膝90度所用时间更短,术中出血量更少,术后3d血红蛋白下降量较少,两组差异明显(P<0.01);手术前两组患者ROM、HSS评分没有明显差异(P>0.05),术后6、12个月ROM、HSS评分...     

单髁置换术与全膝关节置换术治疗膝单间室骨性关节炎的疗效对比分析

目的探讨单髁置换术与全膝关节置换术治疗膝单间室骨性关节炎的疗效。方法选取2017年3月—2018年3月期间南阳南石医院收治的64例膝单间室骨性关节炎患者作为研究对象,依据治疗措施不同平分为对照组和观察组,对照组用全膝关节置换术,观察组用单髁置换术,对比两种方案实施效果。结果治疗后,观察组膝关节屈曲度、膝关节功能评分高于对照组;观察组术中出血量、膝关节屈曲度恢复至90°所需时间低于对照组,满意度高于对照组,差异均有统计学意义(P<0.05)。结论单髁置换术与全膝关节置换术治疗膝单间室骨性关节炎均有一定效果,单髁置换术的应用价值更高,值得应用。     

单髁置换术与全膝关节置换术治疗老年膝关节退行性骨关节炎患者的效果比较

目的：比较单髁置换术与全膝关节置换术治疗老年膝关节退行性骨关节炎患者的效果。方法：回顾性分析2022年1月至2023年1月该院收治的88例老年膝关节退行性骨关节炎患者的临床资料,根据治疗方法不同将其分为对照组（n=38）和观察组（n=50）。对照组采用全膝关节置换术治疗,观察组采用单髁置换术治疗,比较两组手术时间和术中出血量、治疗前后膝关节功能[美国纽约特种外科医院（HSS）膝关节评分]、疼痛程度[视觉模拟评分法（VAS）]评分、生命质量[生活质量综合评定问卷-74(GQOLI-74)]评分,以及并发症发生率。结果：观察组手术时间短于对照组,术中出血量少于对照组,差异均有统计学意义（P<0.05）;治疗后,两组关节活动度、疼痛、关节功能、肌力、屈曲畸形及关节稳定性等各项HSS评分均高于治疗前,且观察组高于对照组,差异有统计学意义（P<0.05）;两组VAS评分均低于治疗前,且观察组低于对照组,差异有统计学意义（P<0.05）;两组物质生活、躯体功能、心理功能、社会功能等各项GQOLI-74评分均高于治疗前,且观察组高于对照组,差异有统计学意义（P<0.05）;两...     

小切口单髁置换和全膝关节置换配对比较临床早期结果

目的：通过配对比较，观察小切口单髁置换和全膝关节置换治疗单室膝关节骨性关节炎的早期临床结果。方法：2001年6－12月，新加坡中央医院采用小切口单髁置换连续治疗50例内侧单室膝关节骨关节炎患者，同时对在年龄、临床症状、膝关节的X线分级上进行配对比较的50例内侧单室膝关节骨关节炎患者进行全膝关节置换。小切口单髁置换组，男9例，女41例；年龄52－85岁，平均64岁。全膝关节置换组，男8例，女42例；年龄55－80岁，平均67岁。临床均表现为膝关节内侧间隙疼痛，Ahlback X线分级I－Ⅲ级。结果：小切口单髁置换组与全膝关节置换组比较，具有出血量少、膝关节功能恢复快、住院时间短、并发症少、创伤小、康复快、费用少等优点。结论：对于单室膝关节骨关节炎，小切口单髁置换与全膝关节置换术比较，其早期临床结果具有明显的优点。     

单髁与全膝置换治疗老年膝单间室骨性关节炎远期疗效的meta分析

目的:采用meta分析评价单髁置换术(UKA)与全膝置换术(TKA)治疗老年膝单间室骨性关节炎的远期疗效。方法:检索PubMed、Embase、Cochrane Library、CNKI数据库,获取UKA与TKA治疗老年膝单间室骨性关节炎的随机对照(RCT)和半随机对照研究(CCT)。采用RevMan 5.0.23对术后远期优良率、翻修率及关节活动度进行meta分析。结果:共纳入6篇文献,RCT 3篇,CCT 3篇。分析结果显示,UKA与TKA术后远期优良率差异无统计学意义,RR(95%CI)=1.07(0.97~1.18),P=0.19;术后翻修率差异亦无统计学意义,RR(95%CI)=1.84(0.86~3.91),P=0.11;术后关节活动度UKA优于TKA,RR(95%CI)=0.36(0.26~0.50),P<0.001。结论:UKA治疗老年膝单间室骨性关节炎在术后关节活动度方面优于TKA。     

人工膝关节置换术治疗重度膝骨性关节炎的临床疗效

目的:探讨人工全膝关节置换治疗骨性关节炎的临床效果。方法:对2008年1月～2011年5月施行的15例人工膝关节置换临床资料进行回顾性总结和分析。结果:15例(16膝)中,优10膝(62.5%),良5膝(31.3%),可1膝(0.63%),优良率93.8%。结论:人工全膝置换术应用于严重骨性关节炎的治疗,能显著提高临床效果,改善患者生活质量,值得在临床上应用和推广。     

单髁置换术与全膝置换术治疗黄土高原地区大骨节病膝关节炎的疗效对比研究

目的 比较单髁置换术(UKA)与全膝置换术(TKA)治疗黄土高原地区大骨节病膝关节炎的疗效差异.方法 选取2017年1月—2018年8月庆阳市人民医院收治的大骨节病膝关节炎患者40例作为研究对象.按手术方式分成UKA组和TKA组,比较两组患者手术时间、术后引流量、膝关节活动度、HSS评分、血红蛋白质量浓度、C反应蛋白等...     

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.     

The clinical comparison of simultaneous bilateral total knee arthroplasty in treatment of osteoarthritis

Objective： To evaluate the risk and efficacy of simultaneous bilateral total knee arthroplasty（TKA） in treatment of osteoarthritis when compared with sequential bilateral TKA and unilateral TKA. Methods：A retrospective analysis was performed on 162 patients who underwent TKA from 2003 to 2006. The analyses were adjusted for demographics, preexisting medical conditions, and osteoar- thrifts diagnosis. Results：Patients undergoing simultaneous bilateral TKA had significantly lower amounts of blood loss, shorter surgical time, shorter hospitalization time, less hospital charges and lower rates of perioperative complications compared with patients undergoing sequential bilateral TKA. No significant difference was found with regard to postoperative complications between the simultaneous bilateral and the unilateral TKA groups. Patient＇ s knee range of motion and the postoperative Hospital for Special Surgery scores（HSS） were similar for the three groups. Conclusion：When there are adequate indications for bilateral TKA, simultaneous bilateral TKA is beneficial to patients compared with sequential bilateral or unilateral TKA.     

The clinical comparison of simultaneous bilateral total knee arthroplasty in treatment of osteoarthritis

Objective: To evaluate the risk and efficacy of simultaneous bilateral total knee arthroplasty(TKA) in treatment of osteoarthritis when compared with sequential bilateral TKA and unilateral TKA. Methods:A retrospective analysis was performed on 162 patients who underwent TKA from 2003 to 2006. The analyses were adjusted for demographics, preexisting medical conditions, and osteoar- thritis diagnosis. Results:Patients undergoing simultaneous bilateral TKA had significantly lower amounts of blood loss, shorter surgical time, shorter hospitalization time, less hospital charges and lower rates of perioperative complications compared with patients undergoing sequential bilateral TKA. No significant difference was found with regard to postoperative complications between the simultaneous bilateral and the unilateral TKA groups. Patient’s knee range of motion and the postoperative Hospital for Special Surgery scores(HSS) were similar for the three groups. Conclusion:When there are adequate indications for bilateral TKA, simultaneous bilateral TKA is beneficial to patients compared with sequential bilateral or unilateral TKA.     

后稳定型全膝置换治疗膝关节骨关节炎近期疗效分析

目的:探讨应用后稳定型全膝假体行全膝置换治疗膝关节骨关节炎的临床疗效。方法:对13例膝关节骨关节炎患者共15个膝关节,术前HSS评分,30～40分5例,40～50分8例,50～60分2例,使用后稳定型全膝假体行全膝置换术,随访(7±2.1)月。结果:13例病人均获得随访。术后无感染及假体松动表现。按照膝关节HSS评分,优11例,良2例,中2例。结论:人工全膝关节置换术可有效缓解骨关节炎疼痛,改善膝关节功能,近期疗效满意。     

双侧同期全膝关节置换和单膝关节置换术临床疗效对比

目的：对双侧同期全膝关节置换和单膝关节置换术的临床疗效进行探究。方法选取我院2013年6月—2014年6月100例膝关节骨性关节炎患者为研究对象,随机分为2组,对照组采取单膝关节置换术,观察组采用双侧同期全膝关节置换术,比较分析2组的临床疗效及患者满意度。结果观察组总有效率和疗效满意度高于对照组,术后疼痛评分（VAS）低于对照组,膝关节功能评分（Lysholm）高于对照组,差异均有统计学意义（P<0.05）。结论双侧同期全膝关节置换术在膝关节骨性关节炎的治疗上可起到重要作用,帮助患者早日康复,有临床推广价值。     

Analysis on hidden blood loss of total knee arthroplasty in treating knee osteoarthritis

Background  Total knee arthroplasty (TKA) is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin (HB) counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis.

Methods  One hundred and eight patients, with 42 males and 66 females, were retrospectively analyzed. The perioperative blood loss and the hidden blood loss following TKA were calculated by Gross formula. Potential factors affecting perioperative and hidden blood loss included gender, surgical time, tourniquet time, hemostasis (during operation with deflating tourniquet), and reinfusion of salvaged blood.

Results  The average perioperative blood loss was found to be (1553±356) ml and the average hidden blood loss was (793±223) ml. The hidden blood loss of the male was significantly higher than that of the female, and was reduced by hemostasis during the operation with a deflating tourniquet. Hidden blood loss was not affected by postoperative blood salvage and reinfusion, surgical time, or tourniquet time.

Conclusions  When calculating the value of hidden blood loss by Gross formula, the lowest value of hematocrit should be chosen as the parameter so that hidden blood loss would not be underestimated. No significant differences could be found in hidden blood loss for males compared to females. Hidden blood loss can be reduced by hemostasis during operation with a deflating tourniquet. Although reinfusion of salvaged blood could not reduce the perioperative blood loss or hidden blood loss, it was still an effective method to reduce transfusion rate.