不均匀沉降术与全膝关节置换术治疗内侧间室膝关节骨性关节炎的对比分析

Comparison of non-uniform settlement and total knee arthroplasty for medial compartment knee osteoarthritis

目的 评价不均匀沉降术与全膝关节置换术（TKA）治疗内侧间室膝关节骨性关节炎（KOA）的临床效果.方法 34例KOA患者,左膝14例,右膝20例,均为内侧间室受累为主的KOA患者.根据手术方法的不同将34例患者分为不均匀沉降术组（16例,观察组）和TKA组（18例,对照组）,对两组患者术后膝关节疼痛缓解程度、HSS膝关节评分以及住院时间和治疗费用进行比较.结果 34例患者术后均获随访,随访时间12 ～ 36个月,平均（15.00＆#177;6.17）个月.观察组患者术后VAS评分、术后优良率、HSS评分虽劣于对照组,但组间比较差异无统计学意义（P＞0.05）;观察组治疗费用、住院时间少于对照组,差异有统计学意义（P＜0.05）.结论 应用不均匀沉降术治疗内侧间室KOA,有创伤小、操作简单、住院时间短、费用低廉、疗效确切.

Objective To discuss the clinical effects of non-uniform settlement and total knee ar- throplasty （TKA）for medial compartment knee osteoarthritis. Methods We chose 34 patients with medial compartment knee osteoarthritis, including 21 males （21 knees） and 13 females （ 13 knees）. The age ranged from 56 to 71 years,with an average of（58.79 ± 12.3 ）years. There were 14 cases of left knees and 20 cases of right knees. All patients were medial compartment knee osteoarthritis. According to methods, patients with non-uniform settlement were enrolled into the observation group（ n = 16）and the others with TKA were enrolled into the control group （n = 18 ）. Visual analogue scale （VAS）, hospital for special surgery（HSS） knee scoring system, therapy cost and hospital stay were compared between groups. Results All 34 cases were followed up for 12 to 36 months, with an average of（ 15 ± 6.17 ） months. The VAS score, HSS score, and excellent and good rate in the observation group were lower but there were no significant differences （ P 〉 0.05 ）. The observation group was superior to the controls in therapy cost and hospital stay and there were significant differences （ P 〈 0.05 ）. Conclusion For medial compartment knee osteoarthri- tis, non-uniform settlement has the advantages of smaller trauma, shorter length of hospital stay and more simple operation, meanwhile its curative effect is obvious,which can be widely applied in the primary hospitals.