OWHTO联合关节镜清理术与UKA治疗膝关节内侧间室骨关节炎效果对比

Comparison of the Effect of OWHTO Combined with Arthroscopic Debridement and UKA in the Treatment of Medial Compartment Osteoarthritis of the Knee

目的:比较开放楔形胫骨高位截骨(open wedge high tibial osteotomy,OWHTO)联合关节镜清理术与单髁关节置换术(unicompartmental knee arthroplasty,UKA)治疗膝关节内侧间室骨关节炎的临床效果。方法:回顾性分析滨州医学院附属医院2020年1月-2021年1月手术治疗的44例膝关节内侧间室骨关节炎患者,按照不同术式分为观察组22例与对照组22例。观察组采用OWHTO联合关节镜清理术,对照组采用UKA。比较两组患者手术相关指标、术后膝关节屈曲度、膝关节功能及并发症发生情况差异。结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05);术后24 h对照组视觉模拟评分法(VAS)评分明显低于观察组,差异有统计学意义(P<0.05);两组术后膝关节屈曲度、美国特种外科医院(HSS)膝关节评分均高于术前(P<0.05),术后1个月及1年,观察组膝关节屈曲度均优于对照组(P<0.05),术后1个月,对照组HSS评分优于观察组(P<0.05),但术后1年两组的HSS评分相比,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:在膝关节内侧间室骨关节炎的临床治疗中,两种手术方式均可获得良好的短期效果,OWHTO联合关节镜清理术具有术后关节活动范围更佳的优点,而UKA可更快更早地改善膝关节功能。

Objective:To compare the clinical efficacy of open wedge high tibial osteotomy(OWHTO)combined with arthroscopic debridement and unicompartmental knee arthroplasty(UKA)in the treatment of medial compartment osteoarthritis of the knee.Method:A retrospective analysis was made on 44 patients with medial compartment osteoarthritis of knee joint treated by surgery in the Affiliated Hospital of Binzhou Medical College from January 2020 to January 2021,they were divided into observation group(22 cases)and control group(22 cases)according to different operation methods.The observation group was treated with OWHTO combined with arthroscopic debridement,the control group was treated with UKA.The differences of operation related indexes,postoperative knee flexion,knee function and complication rate between the two groups were compared.Result:There were no significant differences in operation time and intraoperative bleeding between the two groups(P>0.05);the VAS score at 24 h after operation in the control group was significantly lower than that in the observation group,the difference was statistically significant(P<0.05);the postoperative knee flexion and HSS scores of the two groups were higher than those before operation(P<0.05);the knee flexion degree of the observation group was better than that of the control group at 1 month and 1 year after operation(P<0.05);1 month after operation,the HSS score of the control group was better than that of the observation group(P<0.05),but there was no significant difference in the HSS score between the two groups at 1 year after operation(P>0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:In the clinical treatment of osteoarthritis of the medial compartment of the knee,both surgical methods can achieve good short-term results.OWHTO combined with arthroscopic debridement has the advantage of better postoperative range of motion,while UKA can improve the function of the knee joint faster and earlier.