微创髋关节置换术对膝骨性关节炎关节功能及关节炎症的影响

Effect of minimally invasive hip arthroplasty on joint function and synovial fluid laboratory parameters in patients with knee osteoarthritis

目的探讨微创髋关节置换术对膝骨性关节炎关节功能及关节炎症的影响.方法选取膝骨性关节炎患者90例,根据治疗方式分为微创髋关节置换术组(观察组)45例与传统髋关节置换术组(对照组)45例.比较2组患者的围手术期指标,包括切口长度、手术时间、术中出血量、术后引流量、下床活动时间、住院时间.分别在术前、术后3个月采用美国特种外科医院膝关节功能评分(HSS)评估2组患者的膝关节功能,并检测滑膜液内CRP、ESR、降钙素原水平,记录并发症发生率.结果与对照组相比,观察组患者的切口长度较短、术中出血量较少、住院时间较短(P均<0.05).手术后,2组HSS各项评分均高于手术前(P均<0.05),滑膜液内CRP、ESR、降钙素原水平均低于手术前(P均<0.05),且观察组的肌力、关节活动、关节稳定性、功能、屈曲畸形评分均高于对照组(P均<0.05),滑膜液的CRP、降钙素原水平均低于对照组(P均<0.05).2组患者的切口感染、深静脉血栓、脱位、假体松动发生率比较差异均无统计学意义(P均>0.05).结论与传统髋关节置换术相比,微创髋关节置换术能缩短切口长度及住院时间,减少术中出血量,促进术后关节功能恢复,减轻炎症反应.

Objective To investigate the effect of minimally invasive hip arthroplasty on joint function and synovial fluid laboratory indexes in patients with knee osteoarthritis.Methods Ninety patients with knee osteoarthritis were divided into the control(n=45)and observation groups(n=45)according to the treatment method.In the control group,patients received traditional hip arthroplasty,and those in the observation group underwent minimally invasive hip arthroplasty.The perioperative indexes including incision length,operation time,intraoperative bleeding volume,postoperative drainage volume,ambulation time and length of hospital stay were statistically compared between two groups.The knee joint function was assessed by the American Special Surgical Hospital Knee Function Scale(HSS)before and 3 months after surgery.The levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and procalcitonin(PCT)in the synovial fluid were measured and the incidence of complications was recorded.Results The incision length,intraoperative bleeding volume and length of hospital stay in the observation group were significantly less than those in the control group(all P<0.05).Postoperatively,the HSS scores were remarkably higher than those before treatment in two groups(both P<0.05),whereas the levels of CRP,ESR and PCT in the synovial fluid were significantly lower than those before treatment(all P<0.05).The scores of muscle strength,joint activity,joint stability,function and flexion deformity in the observation group were significantly higher compared with those in the control group(all P<0.05),whereas the levels of CRP and PCT in the synovial fluid were considerably lower than those in control group(both P<0.05).The incidence rate of incision infection,deep venous thrombosis,dislocation and prosthesis loosening did not significantly differ between two groups(all P>0.05).Conclusions Compared with traditional hip arthroplasty,minimally invasive hip arthroplasty can shorten the incision length and length of hospital stay,reduce intraoperative blood loss,promote postoperative recovery of joint function,and mitigate inflammatory reaction.