单间室膝关节置换术治疗老年膝关节内侧单间室骨性关节炎疗效观察

Effect of unicompartmental knee arthroplasty in the treatment of elderly patients with medial compartmental osteoarthritis of the knee joint

目的探讨单间室膝关节置换术(UKA)治疗老年膝关节内侧单间室骨性关节炎的临床效果。方法选择2012年3月至2016年3月平顶山市第二人民医院收治的膝关节内侧单间室骨性关节炎老年患者(≥60岁)120例,根据手术方式分为全膝关节表面置换术(TKA)组和UKA组,每组60例。TKA组患者给予TKA治疗,UKA组患者给予UKA治疗,记录2组患者的术中出血量、手术时间及住院时间,分别于术前及术后1 a采用美国特种外科医院(HSS)评分系统评估2组患者膝关节功能,采用视觉模拟评分法(VAS)评估2组患者的膝关节疼痛情况,并观察2组患者膝关节活动度(ROM)。结果 2组患者手术时间比较差异无统计学意义(P>0.05);UKA组患者术中出血量显著少于TKA组,住院时间显著短于TKA组(P<0.05)。术前2组患者膝关节HSS评分、疼痛VAS评分及膝关节ROM比较差异均无统计学意义(P>0.05);2组患者术后1 a膝关节HSS评分及ROM显著高于术前,疼痛VAS评分显著低于术前(P<0.05);术后1 a,UKA组患者膝关节HSS评分及ROM显著高于TKA组,疼痛VAS评分显著低于TKA组(P<0.05)。UKA组和TKA组患者治疗效果优良率分别为96.67%(58/60)、86.67%(52/60),UKA组患者治疗效果优良率显著高于TKA组(χ~2=3.927,P<0.05)。结论 UKA治疗老年膝关节内侧单间室骨性关节炎具有创伤小、术中出血量少、术后恢复快等优点,可显著改善患者膝关节ROM,提高膝关节功能。

Objective To investigate the effect of unicompartmental knee arthroplasty(UKA)in the treatment of elderly patients with medial compartmental osteoarthritis of the knee joint.Methods A total of 120 elderly patients with medial compartmental osteoarthritis of the knee joint were selected from March 2012 to March 2016 in the Second People′s Hospital of Pingdingshan City.The patients were divided into total knee arthroplasty(TKA)group and UKA group according to the operation,with 60 cases in each group.The patients in the TKA group were treated with TKA,and the patients in the UKA group were treated with UKA.The intraoperative bleeding volume,operation time and hospitalization time were recorded in the two groups.The knee joint function of patients was evaluated by the American hospital for special surgery(HSS)scoring system,and the pain of knee joint of patients in the two groups was evaluated by the visual analogue score(VAS)before and one year after operation,respectively.The range of motion(ROM)of knee joint of patients in the two groups was observed.Results There was no significant difference in the operation time between the two groups(P>0.05).The intraoperative bleeding volume in the UKA group was significantly less than that in the TKA group,and the hospitalization time in the UKA group was significantly shorter than that in the TKA group(P<0.05).There was no significant difference in the HSS score,VAS score and ROM of knee joint between the two groups before operation(P>0.05).Compared with pre-operation,the HSS score and ROM of knee joint were significantly higher,and the VAS score of knee joint was significantly lower at one year after operation in the two groups(P<0.05).The HSS score and ROM of knee joint in the UKA group were significantly higher than those in the TKA group,and the VAS score in the UKA group was significantly lower than that in the TKA group at one year after operation(P<0.05).The fineness rate in the UKA group and TKA group was 96.67%(58/60)and 86.67%(52/60)respectively,and the fineness rate in the UKA group was significantly higher than that in the TKA group(χ2=3.927,P<0.05).Conclusion UKA in the treatment of elderly patients with medial compartmental osteoarthritis of the knee joint has the advantages of less trauma,less intraoperative bleeding and quicker postoperative recovery;which can significantly improve the ROM of knee joint and improve the knee joint function.