膝关节单髁置换在膝内侧间室骨关节炎患者中的疗效及对关节功能、关节相关参数的影响

Effect of Unicondylar Replacement of Knee Joint in the Treatment of Patients with Medial Compartmental Osteoarthritis of Knee and Influence for Joint Function and Joint Related Parameters

目的:探究膝关节单髁置换在膝内侧间室骨关节炎患者中的疗效及对关节功能、关节相关参数的影响。方法:选取2019年1月—2022年11月中国航天科工集团七三一医院收治的100例膝内侧间室骨关节炎患者,根据随机数表法将其分为两组,各50例。对照组进行全膝关节置换术治疗,观察组进行膝关节单髁置换治疗。比较两组的术中出血量、负压引流量、住院时间、手术前后的疼痛程度[视觉模拟评分法(VAS评分)]、关节功能状态[美国特种外科医院膝关节评分(HSS评分)]及关节相关参数(髋膝踝角及关节活动度)。结果:观察组的术中出血量、负压引流量显著少于对照组,住院时间显著短于对照组,差异有统计学意义(P<0.05)。术前,两组的VAS评分比较,差异无统计学意义(P>0.05);术后1个月、3个月,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。术后1个月、3个月,两组HSS评分及关节相关参数均优于术前,差异有统计学意义(P<0.05),但两组间HSS评分及关节相关参数比较差异无统计学意义(P>0.05)。结论:膝关节单髁置换在膝内侧间室骨关节炎患者中的疗效及对关节功能、关节相关参数的影响与全膝关节置换术无显著差异,但其术后不适感更轻微,恢复更快。

Objective:To investigate the effect of unicondylar replacement of knee joint in the treatment of patients with medial compartmental osteoarthritis of knee and influence for joint function and joint related parameters.Method:A total of 100 patients with medial compartmental osteoarthritis of knee in Aerospace Science and Industry Group 731 Hospital from January 2019 to November 2022 were selected,and they were divided into two groups by the random number table method,with 50 cases in each group.The control group was treated with total knee replacement,the observation group was treated with unicondylar replacement of knee joint.Then intraoperative blood loss,drainage volume,hospitalization time,pain degree[visual analogue scale(VAS score)],joint function state[score of Hospital for Special Surgery(HSS score)]and joint related parameters(hip-knee-ankle angle and joint range of motion)before and after the operation of two groups were compared.Result:The intraoperative blood loss and drainage volume of observation group were significantly less than those of control group,the hospitalization time was significantly shorter than that of control group,the differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in VAS scores between the two groups(P>0.05).At 1 month and 3 months after surgery,the VAS scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).At 1 month and 3 months after surgery,the HSS scores and joint related parameters of the two groups were better than those before surgery,the differences were statistically significant(P<0.05),however,there were no statistically significant differences in HSS scores and joint related parameters between the two groups(P>0.05).Conclusion:The efficacy and impact on joint function and joint related parameters of knee joint unicondylar replacement in patients with medial knee compartment osteoarthritis are not significantly different from total knee joint replacement,but its postoperative discomfort is milder and recovery is faster.