单髁置换术与全膝关节置换术治疗膝单间室骨关节炎患者的效果比较

Comparison of effects of unicompartmental arthroplasty and total knee arthroplasty in treatment of patients with single compartment osteoarthritis of knee

目的:比较单髁置换术(UKA)与全膝关节置换术(TKA)治疗膝单间室骨关节炎(KOA)患者的效果。方法:选取88例膝单间室KOA患者为研究对象,采用随机数字表法分为对照组和观察组各44例。对照组实施全膝关节置换术(TKA)治疗,观察组实施UKA治疗,术后随访1年。比较两组围术期相关指标(手术时间、术中出血量)水平、住院时间、治疗前后最大屈膝角度、疼痛程度[视觉模拟评分法(VAS)]评分、膝关节功能[美国特种外科医院膝关节功能(HSS)]评分,以及并发症发生率。结果:观察组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后,两组最大屈膝角度均大于术前,且观察组大于对照组,差异有统计学意义(P<0.05);术后,两组VAS评分均低于术前,HSS评分均高于术前,差异有统计学意义(P<0.05),但组间VAS、HSS评分比较,差异均无统计学意义(P>0.05);观察组并发症发生率为6.82%(3/44),低于对照组的25.00%(11/44),差异有统计学意义(P<0.05)。结论:UKA治疗膝单间室KOA患者可缩短手术时间和住院时间,减少术中出血量,增大最大屈膝角度,降低并发症发生率,效果优于TKA治疗。

Objective: To compare effects of unicompartmental arthroplasty(UKA) and total knee arthroplasty(TKA) in treatment of patients with single compartment osteoarthritis of knee(KOA). Methods: 88 patients with KOA in single compartment of knee were selected as the research objects and were divided into control group and observation group by using the random number table method, 44 cases in each group. The control group was treated with total knee arthroplasty(TKA), while the observation group was treated with UKA. They were followed up for 12 months postoperatively. The levels of perioperative related indicators(operation time, intraoperative blood loss), the hospitalization time, the maximum knee flexion angles before and after the treatment, the pain degree [visual analog scale(VAS)] score, the knee joint function [American hospital for special surgery(HSS)] score and the incidence of complications were compared between the two groups. Results: The operation time and the hospitalization time in the observation group were shorter than those in the control group;the intraoperative blood loss was less than that in the control group;and the differences were statistically significant(P<0.05). After the surgery, the maximum knee flexion angles in both groups were higher than those before the surgery, that of the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05). After the surgery, the VAS scores of the two groups were lower than those before the surgery, and the HSS scores were higher than those before the surgery, and the differences were statistically significant(P<0.05);however, there were no statistical differences in the VAS and HSS scores between the two groups. Further, the incidence of complications in the observation group was 6.82%(3/44), which was lower than 25.00%(11/44) in the control group, and the difference was statistically significant(P<0.05). Conclusions: UKA for the patients with single compartment KOA can shorten the operative time and the hospitalization time, reduce the intraoperative blood loss, increase the maximum knee flexion angles, and reduce the incidence of complications. Moreover, it is superior to TKA.