不同手术方式治疗老年膝内侧间室骨关节炎的疗效对比分析

Comparative Analysis of the Efficacy of Different Surgical Methods in the Treatment of Elderly Knee Medial Compartment Osteoarthritis

目的:比较单踝关节置换术(UKA)和全膝关节置换术(TKA)治疗老年膝内侧间室骨关节炎的疗效。方法:选取2020年1月~2022年6月本院收治的100例老年膝内侧间室骨关节炎患者为研究对象,随机(随机数字表法)分为UKA组(n=50)和TKA组(n=50),采取相应手术方法治疗。比较两组手术相关指标、美国特种外科医院(HSS)膝关节功能评分、膝关节屈伸活动度(ROM)、疼痛视觉模拟评分法(VAS)、健康调查12条简表(SF-12)评分及假体情况。结果:与TKA组相比,UKA组切口长度更短,术中出血量及术后引流量更少,手术时间、下地行走时间及住院时间更短,组间比较差异均有统计学意义(P<0.05)。UKA组术后2周、3个月及6个月时HSS评分均明显高于TKA组(P<0.05)。UKA组术后2周、3个月ROM均明显高于TKA组(P<0.05)。UKA组术后3个月VAS评分明显低于TKA组(P<0.05)。两组SF-12评分中生理及心理维度评分在术后6个月后均明显提高(P<0.05);但组间比较差异均无统计学意义(P>0.05)。两组均无假体翻修病例。结论:UKA相比于TKA具有创伤更小、患者术后恢复更快、膝关节功能恢复更好的优势。

Objective:To compare the efficacy of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of medial compartment knee osteoarthritis in the elderly.Methods:A total of 100 elderly patients with medial compartment knee osteoarthritis admitted to our hospital from January 2020 to June 2022 were selected as the research objects.They were randomly(random number table method)divided into UKA group(n=50)and TKA group(n=50).Take corresponding surgical treatment.The operation related indicators,Hospital for Special Surgery(HSS)knee function score,knee flexion and extension activity(ROM),visual analogue scale(VAS),12-item short form health survey(SF-12)score and prosthesis were compared between the two groups.Results:Compared with the TKA group,the UKA group had shorter incision length,less intraoperative blood loss and postoperative drainage,shorter operation time,walking time and hospitalization time,and the differences were statistically significant(P<0.05).The HSS scores of UKA group were significantly higher than those of TKA group at 2 weeks,3 months and 6 months after operation(P<0.05).The ROM of UKA group was significantly higher than that of TKA group at 2 weeks and 3 months after operation(P<0.05).The VAS score of UKA group was significantly lower than that of TKA group at 3 months after operation(P<0.05).The scores of physiological and psychological dimensions in SF-12 scores of the two groups were significantly increased 6 months after operation(P<0.05).There were no cases of prosthesis revision in both groups.Conclusion:Compared with TKA,UKA has the advantages of less trauma,faster postoperative recovery and better knee function recovery.