人工单髁置换术治疗膝关节单间室骨性关节炎的效果分析

Analysis of the Effect of Artificial Unicompartmental Knee Arthroplasty for Single Compartment Osteoarthritis of Knee Joint

目的:探讨人工单髁置换术治疗膝关节单间室骨性关节炎的临床效果。方法:回顾性分析包头医学院第一附属医院2019年11月-2021年5月收治的54例膝关节内侧间室骨性关节炎患者,根据统一手术适应证的要求,行单髁置换术的24例设为观察组(UKA组),行全膝关节置换术的30例设为对照组(TKA组),记录手术时间、术中出血量、住院天数、患膝并发症,以及术后6个月的疼痛视觉模拟评分法评分(VAS评分)、美国膝关节学会评分(KSS评分)、美国WOMAC骨关节炎指数评分(WOMAC评分)、美国特种外科医院评分(HSS评分)。结果:观察组手术时间、住院天数均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,但差异无统计学意义(P>0.05)。观察组及对照组术后6个月VAS评分、KSS评分、WOMAC评分、HSS评分均优于术前,差异均有统计学意义(P<0.05)。术后6个月,观察组VAS评分及WOMAC评分均低于对照组,KSS评分高于对照组,差异均有统计学意义(P<0.05)。观察组及对照组术后HSS评分差异无统计学意义(P>0.05)。结论:膝关节单髁置换术和全膝关节置换术均在近中期随访中获得满意效果,但单髁置换术治疗膝关节内侧间室骨性关节炎的围手术期数据可观,术后恢复快,近期疗效满意。

Objective:To investigate the clinical effect of artificial unicompartmental knee arthroplasty for single compartment osteoarthritis of knee joint.Method:A retrospective analysis was performed on 54 patients with medial compartment osteoarthritis of the knee joint admitted from November 2019 to May 2021 in the First Affiliated Hospital of Baotou Medical Collge,according to the requirements of unified surgical indications,24 patients undergoing unicompartmental knee arthroplasty were selected as the observation group (UKA group) and 30 patients undergoing total knee arthroplasty were selected as the control group (TKA group).The operation time,intraoperative blood loss and length of stay were recorded.Knee complications and pain visual analogue scale score (VAS score),American knee society score (KSS score),American WOMAC osteoarthritis index score (WOMAC score),and Hospital for Special Surgery score (HSS score) at 6 months after surgery were recorded.Result:The operation time and hospitalization days in the observation group were shorter than those in the control group,intraoperative blood loss was less than that in the control group,the differences were all significant (P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was not statistically significant (P>0.05).Six months after surgery,the VAS score,KSS score,WOMAC score and HSS score of the observation group and the control group were better than those before surgery,with statistically significant differences (P<0.05).Six months after surgery,VAS score and WOMAC score of the observation group were lower than those of the control group,the KSS score of the observation group was higher than that of the control group,the differences were all significant (P<0.05),there was no significant difference in HSS score between the observation group and the control group (P>0.05).Conclusion:Both unicompartmental knee arthroplasty and total knee arthroplasty have achieved satisfactory results in the near and middle follow-up period.However,unicompartmental knee arthroplasty in the treatment of medial compartment osteoarthritis of the knee joint has considerable perioperative data,quick postoperative recovery and satisfactory short-term efficacy.