膝关节内侧单间室骨性关节炎的临床对照研究

Clinical Controlled Study of Medial Single Ventricular Osteoarthritis of Knee Joint

目的:比较Oxford膝关节单髁置换(unicompartmental knee arthroplasty,UKA)与胫骨高位截骨(high tibialosteotomy,HTO)治疗膝关节内侧单间室骨性关节炎的疗效。方法:回顾性分析Oxford膝关节UKA与HTO治疗膝关节内侧单间室骨性关节炎的资料,其中UKA组65例,HTO组45例,对2组手术时间、术中出血量、术后3 d血红蛋白下降量、住院时间进行比较;采用膝关节侧位片测量股骨胫骨角(FTA)、胫骨平台后倾角(PS)、Insall-Salvati(IS)指数、Blackbume peezh(BP)指数、美国膝关节协会评分(American knee society knee score,KSS)及视觉模拟评分(visualanalogue scale,VAS)比较2组术前、术后3月、术后1年情况。结果:110例均获得随访,UKA组在手术时间、术中出血量、术后3 d血红蛋白下降量及住院时间方面均低于HTO组(P<0.05);UKA组和HTO组术后3月、术后1年FTA、PS、IS、BP、VAS、KSS评分与术前比较,差异均有统计学意义(P<0.05)。结论:Oxford膝关节UKA与HTO治疗膝关节内侧单间室骨性关节炎,前者更具有优势,且安全性高,值得临床推广。

Objective To compare the efficacies of unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)in the treatment of unicompartmental osteoarthritis of inner knee.Methods The data of UKA and HTO in the treatment of unicompartmental osteoarthritis of the inner knee were retrospectively analyzed.The patients were divided into UKA group(65 cases)and HTO group(45 cases),and the operation time,intraoperative blood loss,postoperative 3d hemoglobin decrease and hospitalization time were compared.The femoral tibial angle(FTA),tibial platform rear angle(PS),insall-salvati(IS)index,Blackbume peezh(BP)index,American knee society knee score(KSS)and visual analogue scale(VAS)of two groups were compared before surgery,3 months after surgery and 1 year after surgery.Results All the 110 patients were followed up,and the UKA group was lower than the HTO group in terms of operation time,intraoperative blood loss,postoperative 3d hemoglobin decrease and hospitalization time(P<0.05);in 3 months after surgery and 1 year after surgery,FTA,PS,IS,BP,VAS and KSS scores of UKA group and HTO group had statistically significant difference compared with those before surgery(P<0.05).Conclusions In the case of UKA and HTO in the treatment of unicompartmental osteoarthritis of the inner knee,relatively speaking,the former is more advantageous and has high safety,which is worthy of clinical promotion.