膝单髁置换术与全膝置换术治疗膝单间室骨性关节炎的效果比较

A clinical comparative study of unilateral ankle replacement and total knee replacement in the treatment of knee osteoarthritis with single compartment

目的探讨膝单髁置换术(UKA)和全膝置换术(TKA)治疗膝单间室骨性关节炎的临床效果。方法选取2018年4月至2020年4月晋城市人民医院骨科收治的98例膝单间室骨性关节炎患者,男57例,女41例,年龄(65.33±2.59)岁,年龄范围为56~72岁。根据手术方法的不同将患者分为UKA组(n=51)与TKA组(n=47),比较两组患者围术期指标[手术时间、切口长度、术中出血量、术后1 d的视觉模拟评分法(VAS)评分、首次直腿抬高时间、术后住院时间],术后6、12个月最大屈膝角度,胫骨-胫骨角,纽约特种外科医院膝关节(HSS)评分,同时观察治疗期间并发症的发生情况。结果UKA组切口长度[(7.33±1.25)cm]短于TKA组[(12.35±1.18)cm],术中出血量[(120.56±3.47)ml]少于TKA组[(258.77±3.20)ml],术后1 d的VAS评分[(2.66±1.21)分]低于TKA组[(3.25±1.46)分],首次直腿抬高时间[(2.64±1.02)d]短于TKA组[(4.25±1.45)d],术后住院时间[(5.30±1.21)d]短于TKA组[(7.63±1.59)d],术后12个月,UKA组患者最大屈膝角度[(118.25±6.23)°]、胫骨-胫骨角[(180.69±4.11)°]及HSS评分[(92.58±6.13)分]均高于TKA组[(110.78±5.17)°、(177.65±3.98)°、(90.15±4.37)分],差异均有统计学意义(P<0.05)。结论UKA及TKA用于治疗膝单间室骨性关节炎均可获得较好的效果,但UKA围术期表现及预后均优于TKA,且没有增加并发症发生率,安全性较高,值得在临床上推广应用。

Objective To investigate the clinical effects of knee unilateral ankle replacement(UKA)and total knee replacement(TKA)in the treatment of knee unicompartmental osteoarthritis.Methods A total of 98 patients with knee unicompartment osteoarthritis who were admitted to the department of orthopedics of Jincheng People′s Hospital from April 2018 to April 2020 were selected,and their clinical data were retrospectively analyzed.There were 57 males and 41 females,aged(65.33±2.59)years old,ranging from 56 to 72 years old.According to different surgical methods,patients were divided into UKA group(n=51)and TKA group(n=47).The perioperative indexes of the two groups were compared[operation time,incision length,intraoperative blood loss,postoperative 1 d visual analogue scale(VAS)score,first straight leg elevation time,postoperative hospital stay],maximum knee flexion angle at 6 and 12 months after surgery,tibia-tibial angle,NewYork hospital for special surgery(HSS)score,and observe the occurrence of complications during treatment.Results The incision length[(7.33±1.25)cm]in the UKA group was shorter than that in the TKA group[(12.35±1.18)cm],and the intraoperative blood loss[(120.56±3.47)ml]was less than that in the TKA group[(258.77±3.20)ml],VAS score[(2.66±1.21)points]1 day after operation was lower than TKA group[(3.25±1.46)points],and the first straight leg elevation time[(2.64±1.02)d]was shorter than TKA group[(4.25±1.45)d],the postoperative hospital stay[(5.30±1.21)d]was shorter than the TKA group[(7.63±1.59)d],12 months after surgery,the maximum knee flexion angle of patients in the UKA group was[(118.25±6.23)°],tibia-tibia angle[(180.69±4.11)°]and HSS score[(92.58±6.13)points]are higher than the TKA group[(110.78±5.17)°,(177.65±3.98)°,(90.15±4.37)Points],the differences were statistically significant(P<0.05).Conclusion Both UKA and TKA can be used to treat knee unicompartmental osteoarthritis.Both UKA and TKA can achieve better results.However,UKA′s perioperative performance and prognosis are better than TKA,and it does not increase the incidence of complications.It has high safety and is worthwhile Promote and apply clinically.