单髁置换术对老年膝关节骨性关节炎患者康复的影响

Effect of Unicompartmental Knee Arthroplasty on Rehabilitation of Elderly Patients with Knee Osteoarthritis

目的:研究单髁置换术(UKA)治疗老年膝关节骨性关节炎(KOA)的临床效果及对患者康复的影响。方法:选择2015年1月-2016年6月在本院接受UKA的50例老年KOA患者作为观察组,另选同期在本院接受全膝关节置换术(TKA)的50例老年KOA患者作为对照组。比较两组手术时间、术中出血量和引流量,在手术前后使用相关量表评价患者膝关节活动度、膝关节功能指数、疼痛程度和睡眠质量的变化,评价其手术情况及康复情况。比较两组术后不良反应的发生情况,并在术后12、24、36个月随访,使用美国特种外科医院膝关节评分系统(HSS)对患者进行临床评分。结果:观察组的手术总时长明显短于对照组,术中出血量和引流量均明显少于对照组,差异均有统计学意义(P<0.05)。术后,两组患者的ROM和KSS评分均明显高于术前,且观察组均显著高于对照组,差异均有统计学意义(P<0.05)。术后,两组患者的VAS和PSQI评分均明显低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组的不良反应发生率为8.00%,显著低于对照组的24.00%,差异有统计学意义(P<0.05)。术后随访12、24、36个月,两组患者HSS评分均较术前升高,且观察组均显著高于对照组,差异均有统计学意义(P<0.05)。结论:采用UKA治疗老年KOA的临床效果显著,安全性高,患者术后康复好。

Objective:To study the clinical effect of unicompartmental knee arthroplasty(UKA)in the treatment of senile knee osteoarthritis(KOA)and its effect on patients’rehabilitation.Method:A total of 50 elderly patients with KOA who underwent UKA in our hospital from January 2015 to June 2016 were selected as the observation group,and another 50 elderly patients with KOA who underwent total knee arthroplasty(TKA)in our hospital at the same time were selected as the control group.Before and after the operation,the changes of knee joint activity,knee joint function index,pain degree and sleep quality were evaluated by using the related scale,and the operation condition and rehabilitation condition were evaluated.The adverse reactions were recorded and compared.Patients were followed up at 12,24,and 36 months after surgery,and clinical scores were obtained using the HSS.Result:The total duration of the operation in the observation group was significantly shorter than that in the control group,and the intraoperative blood loss and drainage volume were significantly less than those in the control group,with statistically significant differences(P<0.05).After surgery,ROM and KSS scores of patients in both groups were significantly higher than those of before surgery,and the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05).Postoperative VAS and PSQI scores of patients in both groups were significantly lower than those of before surgery,and the observation group were lower than those of the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions in the observation group was 8.00%,significantly lower than 24.00%in the control group,the difference was statistically significant(P<0.05).After 12,24 and 36 months of postoperative follow-up,HSS scores of patients in both groups were higher than those of before surgery,and the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05).Conclusion:The UKA for the treatment of elderly KOA of the clinical effect is significant,high safety,good postoperative rehabilitation.