单间室膝关节置换术治疗膝关节内侧单间室骨性关节炎的效果

Effect of unicompartmental knee arthroplasty on unicompartmental medial osteoarthritis of the knee

目的探讨单间室膝关节置换术治疗膝关节内侧单间室骨性关节炎的效果。方法选取采用单间室膝关节置换术治疗的膝关节内侧单间室骨性关节炎患者30例作为单间室置换组,另选同期行全膝关节置换术治疗的30例患者作为全膝置换组。对比两组治疗前后美国特种外科医院(HSS)评分、膝关节活动度(ROM)和视觉模拟评分法评分,术中失血量、手术时间、住院时间、医疗费用。结果治疗后,两组患者的HSS评分、ROM和视觉模拟评分法评分均较术前显著改善,单间室置换组的HSS评分(92.44±5.21)分显著高于全膝置换组的(83.34±5.67)分,ROM(114.45±15.21)°显著大于全膝置换组的(101.12±10.06)°,视觉模拟评分法评分(1.45±0.13)分显著低于全膝置换组的(2.78±0.56)分,差异均具有统计学意义(P<0.05)。单间室置换组术中失血量(192.23±15.45)ml少于全膝置换组的(254.45±35.12)ml,手术时间(92.21±5.13)min、住院时间(12.17±2.02)d均短于全膝置换组的(124.34±15.12)min、(15.45±5.45)d,医疗费用(4.57±1.01)万元少于全膝置换组的(5.23±1.41)万元,差异均具有统计学意义(P<0.05)。结论采用单间室膝关节置换术治疗膝关节内侧单间室骨性关节炎,术中创伤小,可缩短手术时间,减少手术失血量,缩短住院时间,缓解患者疼痛和改善膝关节功能,且医疗费用较全膝关节置换术低,是一种值得推广的手术方式。

Objective To discuss the effect of unicompartmental knee arthroplasty on unicompartmental medial osteoarthritis of the knee.Methods 30 patients with unicompartmental medial osteoarthritis of the knee treated by unicompartmental knee arthroplasty were selected as the unicompartmental replacement group,and another 30 patients treated by total knee arthroplasty at the same time were selected as the total knee arthroplasty group.Comparison was made on hospital for special surgery(HSS)score,range of motion(ROM),visual analogue scale score,intraoperative blood loss,operation time,hospitalization time,and hospitalization costs.Results After treatment,the HSS score,ROM and visual analogue scale score of the two groups were better than those of this group before treatment;the HSS score(92.44±5.21)points of the unicompartmental replacement group was significantly higher than(83.34±5.67)points of the total knee arthroplasty group,the ROM(114.45±15-21)°was significantly greater than(101.12±10.06)° of the total knee arthroplasty group,and the visual analogue scale score(1.45±0.13)points was significantly lower than(2.78±0.56)points of the total knee arthroplasty group.All the differences were statistically significant(P<0.05).The intraoperative Wood loss(192.23±15.45)ml of the unicompartmental replacement group was less than(254.45±35.12)ml of the total knee arthroplasty group,the operation time(92.21±5.13)min and hospitalization time(12.17±2.02)d were shorter than(124.34±15.12)min and(15.45±5.45)d of the total knee arthroplasty group,and the hospitalization costs(4.57±1.01)ten thousand yuan was less than(5.23±1.41)ten thousand yuan of the total knee arthroplasty group.All the differences were statistically significant(P<0.05).Conclusion Unicompartmental knee arthroplasty has less trauma for the treatment of unicompartmental medial osteoarthritis of the knee,which can shorten the operation time,reduce the intraoperative blood loss,shorten the hospitalization time,relieve the patient's pain and improve the knee function,and the medical cost is lower than total knee arthroplasty.It is a surgical method worthy of promotion.