两种手术方式治疗膝内侧间室骨关节炎早期疗效比较

Early Outcome of two Operative Methods for Knee Medial Compartment Osteoarthritis

目的比较单髁置换术和胫骨高位截骨术治疗膝单间室骨关节炎的术后早期临床疗效,为临床选择适当的治疗方法提供参考。方法选择2016年3月至2017年3月收治并符合纳入排除标准的51例膝关节内侧间室骨关节炎患者,根据患者意愿分为两组。其中,单髁置换术(unicompartmental knee arthroplasty,UKA)组35例,胫骨高位截骨术(high tibial osteotomy,HTO)组16例。记录并比较两组患者手术时间、止血带时间、围手术期总失血量、术后早期疼痛视觉模拟量表、术前和术后3个月美国特种外科医院(the hospital special surgery,HSS)评分和西安大略和麦克马斯特大学骨关节炎指数评分(the western Ontario and McMaster universities osteoarthritis index,WOMAC)等指标。结果两组患者均获随访,单髁置换术组随访时间6~24个月,平均15.3个月;胫骨高位截骨术组随访时间7~22个月,平均14.5个月。两组患者一般资料和随访时间差异无统计学意义。两组患者手术相关因素比较,手术时间、止血带时间差异均无统计学意义;UKA组在失血量、术后16h疼痛视觉模拟量表评分优于HTO组;两组组内HSS评分、WOMAC评分术前和术后比较差异均有统计学意义,组间比较差异均无统计学意义。结论采用单髁置换术和胫骨高位截骨术治疗膝关节单间室骨关节炎均可以获得良好的早期疗效。

Objective To compare early postoperative clinical outcome of unicompartmental knee arthroplasty and high tibial osteotomy for treatment of knee medical compartment osteoarthritis and provide a reference for clinical selection of treatment.Methods 51 patients with knee medial compartmental osteoarthritis admitted from March 2016 to March 2017 and met the inclusion criteria were selected.They were divided into 2 groups according to the wishes of patients.The operative time,tourniquet time,perioperative total blood loss,visual analog scale for postoperative pain,preoperative and postoperative 3 months HSS score,WOMAC score were recorded and compared between the two groups.Results There was no statistical difference in general data between the two groups.There was no significant difference in the operation time and tourniquet time between the two groups;the UKA group had a better visual analog scale in postoperative 16-hour pain assessment than the HTO group in terms of blood loss;HSS score and WOMAC in both groups were statistically different before and after surgery.There was no statistically significant difference between groups.Conclusion Unicompartmental knee arthroplasty and high tibial osteotomy can achieve good early results in the treatment of knee joint osteoarthritis.