活动与固定平台在单髁膝关节置换术治疗膝内侧间室骨关节炎中的疗效比较

Comparison effect of mobile-bearing and fixed-bearing unicompartmental knee arthroplasty foRmedial compartment osteoarthris of the knee

目的比较活动与固定平台两种假体在行单髁膝关节置换术(UKA)治疗膝内侧间室骨关节炎中的疗效。方法将111例行UKA治疗的膝内侧间室骨关节炎患者根据使用假体的不同分为活动平台组(采用Oxford活动平台假体治疗,63例)和固定平台组(采用ZUK固定平台假体治疗,48例)。比较两组手术时间及术后膝关节屈曲活动度(ROM)、疼痛VAS评分、KSS评分、髋膝踝角(HKA)。结果患者均获得随访,时间2~4年。手术时间两组比较差异无统计学意义(P>0.05)。疼痛VAS评分、KSS评分、膝关节屈曲ROM:两组术后2年均优于术后1周(P<0.001),术后1周、2年两组间比较差异均无统计学意义(P>0.05)。术前、术后1周HKA两组比较差异均无统计学意义(P>0.05);但HKA差值(术后1周-术前)活动平台组大于固定平台组(P<0.05)。结论UKA治疗膝内侧间室骨关节炎在严格把握适应证和规范手术操作的前提下,活动与固定平台两种假体均可取得满意的临床疗效,活动平台在恢复下肢力线方面更有优势。

Objective To compare the effect of unicompartmental knee arthroplasty(UKA)on medial compartment osteoarthritis of knee with two kinds of prostheses of mbobile-bearing and fixed-bearing.Methods The 111 patients with medial compartment osteoarthritis of the knee treated with UKA were divided into two groups according to using different prostheses,and 63 patients were adopted with the Oxford mobile-bearing prostheses,48 cases were used ZUK fixed-bearing prostheses.The operation time,knee flexion range of motion(ROM),pain visual analogue score(VAS),KSS score and hip-knee-ankle angle(HKA)were compared between the two groups.Results All patients were followed up foR2~4 years.There was no significant difference in operation time between the two groups(P>0.05).At 2 years postoperation,the pain VAS,KSS score and knee flexion ROM of the two groups were betteRthan those at 1 week afteRsurgery(P<0.001);there were no significant differences between the two groups at 1 week,2 years afteRsurgery(P>0.05).There was no significant difference in HKA between the two groups before and 1 week afteRsurgery(P>0.05);however,the HKA difference(the value of 1 week afteRsurgery subtracted before surgery)of the mobile-bearing group was biggeRthan that of the fixed-bearing group(P<0.05).Conclusions In the treatment of medial compartment osteoarthritis of knee with UKA,both mobile-bearing and fixed-bearing prostheses can achieve satisfactory clinical results undeRthe premise of strictly grasping the indications and standardizing the operation,and the mobile-bearing has more advantages in restoring the strength aligment of loweRlimbs.