全膝关节置换术与单髁置换术对膝关节前内侧骨关节炎肢体功能和并发症的早期疗效分析

Effects of total knee arthroplasty and unicompartmental knee arthroplasty on limb function and complications in patients with anteromedial knee osteoarthritis

目的:探讨全膝关节置换术(TKA)与单髁置换术(UKA)对膝关节前内侧骨关节炎患者肢体功能和并发症的早期疗效。方法:回顾性分析132例膝关节前内侧骨关节炎患者的临床资料。分别采用UKA、TKA将治疗者纳入观察组(n=60)、对照组(n=72),分析不同手术方式对患者肢体功能及并发症的影响。结果:观察组的手术时间、膝关节自主屈曲至90°时间、住院时间均低于对照组,切口长度短于对照组,术中出血量少于对照组(P<0.05);观察组术后膝关节活动度、生活质量评分(QOL)评分高于对照组,疼痛评分(VAS)、白细胞介素-6(IL-6)、IL-17、肿瘤坏死因子(TNF-α)均低于对照组(P<0.05);两组胫骨机械轴夹角(HKA)、胫骨后倾角(PTSA)、股骨远端外侧角及股骨远端外侧角(MPTA)及并发症发生率比较,差异均无统计学意义(P>0.05)。结论:在膝关节前内侧骨关节炎患者临床治疗中,UKA相较TKA具有创伤小、膝关节功能恢复更佳优点,应用安全,值得在临床推广应用。

Objective:To investigate the early curative effect of total knee arthroplasty(TKA) and unicompartmental knee arthroplasty(UKA) on limb function and complications in patients with anteromedial knee osteoarthritis.Methods:The clinical data of 132 patients with anteromedial osteoarthritis of the knee were analyzed retrospectively.The patients treated with UKA and TKA were included in the observation group(n=60) and the control group(n=72),and the effects of different surgical methods on the limb function and complications of the patients were analyzed.Results:The operation time, time for knee flexion reaching 90°,hospital stay, incision and intraoperative blood loss of the observation group were shorter/less than those of the control group(P<0.05).The knee joint activity and quality of life(QOL) score of the observation group were higher than those of the control group, visual analogue scale(VAS) score, Interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and Interleukin-17(IL-17) were lower than those of the control group(P<0.05).There was no difference in the incidence of hip-knee-ankle angle(HKA),posterior tibial slope(PTSA),medial proximal tibia angle(MPTA) and complications between the two groups(P>0.05).Conclusion:Compared with TKA,UKA has characteristics of less trauma and better knee function recovery in clinical treatment of patients with anteromedial knee osteoarthritis.It is safe and worthy of clinical application.