单髁关节置换与全膝关节置换治疗膝单间室骨关节炎的临床比较

Clinical Comparison of Unicompartmental Joint Replacement and Total Knee Replacement in the Treatment of Single-compartment Knee Osteoarthritis

目的对比分析膝单间室骨关节炎患者采用全膝关节置换或单髁关节置换的临床疗效及应用价值。方法该次研究抽选2017年1月—2018年12月上海交通大学附属瑞金医院收治膝单间室骨关节炎患者96例作为研究目标,根据入院时间先后进行分组,对照组采取全膝关节置换手术治疗,观察组采取单髁关节置换手术治疗,记录且对比两组患者临床相关指标差异,观察且评估各组患者治疗前后膝关节屈曲度变化及功能恢复情况,计算各组患者术后并发症发生率。结果观察组患者术中出血量(159.65±23.13)mL明显少于对照组,手术时长(44.95±5.95)min、患者住院总时间(7.13±1.94)d均明显短于对照组,术后3 d血红蛋白下降量(13.11±2.95)g/L低于对照组,差异有统计学意义(t=29.460、8.830、12.180、16.120,P<0.05)。两组患者入院时膝关节屈曲度、关节功能等差异无统计学意义(P>0.05),经过治疗后有所改善,观察组患者膝关节屈曲度大于对照组,关节功能相应评分均高于对照组,差异有统计学意义(P<0.05)。另外,观察组患者术后出现并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论膝单间室骨关节炎患者采取单髁关节置换治疗效果确切,能够有效改善患者关节功能,具有出血量少、安全性高等优点。

Objective To compare and analyze the clinical efficacy and application value of total knee replacement or unicondylar joint replacement in patients with single-compartment knee osteoarthritis.Methods The study time range was from January 2017 to December 2018.96 cases of knee osteoarthritis patients in Ruijin Hospital affiliated to Shanghai Jiaotong University were selected as the research target.They were divided into two groups according to the time of admission,and the control group adopted total knee replacement surgery,the observation group was treated with unicondylar joint replacement surgery.The differences in clinical related indicators between the two groups were recorded and compared.The changes in knee flexion and functional recovery before and after treatment in each group were observed and evaluated,and the patients in each group were calculated the probability of postoperative complications.Results The intraoperative blood loss(159.65±23.13)mL of the observation group was significantly less than that of the control group.The operation time(44.95±5.95)min and the total hospital stay(7.13±1.94)d were significantly shorter than those of the control group.Hemoglobin was 3 days after operation.The amount of decrease(13.11±2.95)g/L was lower than that of the control group,the difference was statistically significant(t=29.460,8.830,12.180,16.120,P<0.05).There was no significant difference in knee flexion and joint function between the two groups of patients on admission(P>0.05),but improved after treatment.The knee flexion of the observation group was greater than that of the control group,and the corresponding scores of joint function were higher than those of the control Group,the difference was statistically significant(P<0.05).In addition,the incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The effect of unicompartmental joint replacement for patients with single-compartment knee osteoarthritis is definite,which can effectively improve the joint function of patients,has the advantages of less bleeding and high safety,and is worthy of popularization and application.