UKA与关节镜辅助HTO治疗膝关节单侧骨性关节炎的近远期疗效观察

Short-term and long-term curative effects of UKA and arthroscopic-assisted HTO in the treatment of unilateral knee osteoarthritis

目的:观察单髁置换术(UKA)与关节镜辅助胫骨高位截骨术(HTO)治疗膝关节单侧骨性关节炎的近远期疗效。方法:根据术式不同将257例膝关节单侧骨性关节炎患者分为UKA组(n=152)和HTO组(n=105),分别采用UKA治疗和关节镜辅助HTO治疗;比较两组患者围手术期指标、近远期疗效及并发症情况。结果:UKA组术中出血量小于HTO组,术后首次下床活动时间、住院时间均短于HTO组(P<0.05);UKA组的术后3个月治疗优良率高于HTO组(P<0.05);两组末次随访膝关节活动度(ROM)与术前比较,差异均无统计学意义(P>0.05);美国特种外科医院膝关节评分(HSS)均较术前提高(P<0.05),疼痛程度[视觉模拟量表(VAS)]评分均较术前降低(P<0.05),但两组组间比较差异无统计学意义(P>0.05);UKA组术后并发症总发生率低于HTO组(P<0.05)。结论:UKA与关节镜辅助HTO治疗膝关节单侧骨性关节炎远期疗效相当,但UKA近期疗效更好,且并发症更少。

Objective:To observe the short-term and long-term curative effects of unicompartmental knee arthroplasty(UKA)and arthroscopic-assisted high tibial osteotomy(HTO)in the treatment of unilateral knee osteoarthritis.Methods:257 patients with unilateral knee osteoarthritis were divided into UKA group(n=152)and HTO group(n=105)according to different surgical procedures.UKA and arthroscopic-assisted HTO were used respectively.The perioperative indicators,short-term and long-term curative effects and occurrence of complications were compared between the two groups.Results:The intraoperative blood loss in the UKA group was less than that in the HTO group,and postoperative first ambulation time and hospital stay were shorter than those in the HTO group(P<0.05).The excellent and good rate of treatment in the UKA group at 3 months after surgery was higher than that in the HTO group(P<0.05).There was no statistical significance in the knee range of motion(ROM)between the two groups at the last follow-up and before surgery(P>0.05),and the Hospital for Special Surgery(HSS)knee score was enhanced compared with that before surgery(P<0.05),while the pain degree[Visual Analogue Scale(VAS)]was reduced compared with before surgery(P<0.05),there were no statistical differences between the two groups(P>0.05).The total incidence rate of postoperative complications in the UKA group was lower than that in the HTO group(P<0.05).Conclusion:UKA and arthroscopic-assisted HTO have no significant differences in the long-term curative effect of treating unilateral knee osteoarthritis,but UKA has better short-term curative effect and fewer complications.