膝关节单髁置换术和全膝置换术对膝关节内侧间室骨关节炎的近期疗效比较

Comparison of Short-term Efficacy between Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty in the Treatment of Medial Compartment Osteoarthritis of Knee Joint

目的:比较膝关节单髁置换术和全膝置换术治疗膝关节内侧间室骨关节炎的近期疗效。方法:选2018年1月-2019年12月在笔者所在医院治疗的膝关节内侧间室骨关节炎患者87例进行回顾性分析,对照组42例,用全膝关节置换术(Zimmer全膝关节假体),观察组45例,用膝关节单髁置换术(Oxford活动平台单髁假体)。对比两组手术相关指标、膝关节功能、关节屈伸活动度情况。结果:观察组手术时长住院时长比对照组短,术中出血量及术后引流量比对照组少(P<0.05);手术治疗后7 d,1、3个月,观察组膝关节功能HSS评分、关节活动度ROM均优于对照组(P<0.05),两组术后6个月HSS评分及ROM差异无统计学意义(P>0.05)。结论:对膝关节内侧间室骨关节炎患者采用膝关节单髁置换术治疗,能较好地改善患者膝关节功能及活动度,具有手术创伤小、手术时间短、术后康复快等优点,近期疗效优于全膝关节置换,手术各项指标良好,可推广。

Objective:To compare the short-term effect of unicondylar knee arthroplasty and total knee arthroplasty for medial compartment osteoarthritis of knee joint.Method:A total of 87 patients with medial compartment osteoarthritis of knee joint treated in our hospital from January 2018 to December 2019 were analyzed retrospectively,control group(n=42)with total knee arthroplasty(Zimmer total knee prosthesis),observation group(n=45)with unicondylar knee arthroplasty(Oxford mobile platform unicondylar prosthesis).The operation related indexes,knee joint function and the range of motion of joint flexion and extension were compared between the two groups.Result:The duration of operation and hospitalization in the observation group were shorter than those in the control group,and the amount of intraoperative hemorrhage and postoperative drainage were less than those in the control group(P<0.05).After 7 days,1 month and 3 months of surgical treatment,the HSS and ROM of the knee joint in the observation group were better than those in the control group(P<0.05).The HSS and ROM after 6 months of surgical treatment had no significant difference(P>0.05).Conclusion:Unicondylar knee arthroplasty for patients with medial compartment osteoarthritis of the knee joint can better improve the knee joint function and range of motion of the patients,and has the advantages of less trauma,shorten operation time and improve postoperative recovery.The short-term effect of unicondylar knee arthroplasty is better than total knee arthroplasty.The operation indexes are good and can be popularized.