全膝关节置换术与单髁置换术治疗膝关节骨性关节炎的疗效比较

Comparison effect of total knee arthroplasty and unicompartmental knee arthroplasty in the treatment of knee osteoarthritis

目的探讨全膝关节置换术与单髁置换术治疗膝关节骨性关节炎的疗效。方法将125例膝关节骨性关节炎患者根据治疗方法不同分为全膝置换组(64例)和单髁置换组(61例)。比较两组手术时间、住院时间、术中出血量、术后引流量。术后采用疼痛VAS评分、HSS评分、人工关节被遗忘指数评分(FJS)对膝关节疼痛及功能进行评价。结果手术时间、住院时间、术中出血量、术后引流量单髁置换组均明显短(少)于全膝置换组(P<0.001)。两组患者均获得12个月随访。术后及术后12个月两组VAS评分、HSS评分均优于术前(P<0.05),两组间比较差异均无统计学意义(P>0.05)。术后12个月,单髁置换组FJS评分高于全膝置换组(P<0.05)。至末次随访时,全膝置换组术后翻修3例,翻修率4.7%,单髁置换组术后翻修2例,翻修率3.3%,两组比较差异无统计学意义(P>0.05)。结论与全膝关节置换术比较,单髁置换术治疗膝关节骨性关节炎手术时间短,创伤小,术后患者主观感受更好。

Objective To explore the effect of total knee arthroplasty and unicompartmental knee arthroplasty on knee osteoarthritis.Methods The 125 patients with knee osteoarthritis were divided into total knee arthroplasty group(64 cases)and unicompartmental knee arthroplasty group(61 cases).The operation time,hospitalization time,intraoperative bleeding volume and postoperative drainage volume were compared between the two groups.The pain and function of knee joint were evaluated by pain VAS,HSS score and forgotten joint score(FJS).Results The operation time,hospitalization time,intraoperative bleeding volume and postoperative drainage volume in the unicompartmental knee arthroplasty group were shorter(less)than those of the total knee arthroplasty group(P<0.001).Both groups were followed up for 12 months.After operation and 12 months after operation,the scores of VAS and HSS were both better than those before operation(P<0.05).There were no significant differences between the two groups(P>0.05).At 12 months after operation,the score of FJS was higher in the unicompartmental knee arthroplasty group than that of the total knee arthroplasty group(P<0.05).At the last follow-up,there were 3 cases of revision in the total knee arthroplasty group,the revision rate was 4.7%,there were 2 cases of revision in the unicompartmental knee arthroplasty group,the revision rate was 3.3%,there was no significant difference between the two groups(P>0.05).Conclusions Compared with total knee arthroplasty,unicompartmental knee arthroplasty in the treatment of knee osteoarthritis has shorter operation time,less trauma and better subjective feeling.