OWHTO与UKA对膝关节内侧间室骨关节炎的临床疗效

Clinical Efficacy of OWHTO and UKA in the Treatment of Medial Compartmental Knee Osteoarthritis

目的:比较膝关节内侧间室骨关节炎患者应用开放楔形胫骨高位截骨术(OWHTO)与单髁置换术(UKA)治疗的效果。方法:选取2019年4月-2022年4月石家庄市第三医院收治的110例膝关节内侧间室骨关节炎患者作为研究对象,按随机数表法将其分为对照组和观察组,各55例。对照组给予UKA治疗,观察组给予OWHTO治疗,比较两组手术相关指标,以及术前、术后3个月视觉模拟评分法(VAS)评分、膝关节功能、屈膝最大角度及髌骨高度。结果:观察组手术时间、住院时间均长于对照组,术中出血量多于对照组,差异有统计学意义(P<0.05)。术前,两组VAS评分、膝关节功能、屈膝最大角度、髌骨高度比较,差异无统计学意义(P>0.05);术后3个月,两组VAS评分、胫股角(FTA)水平低于术前,且观察组低于对照组,美国特种外科医院膝关节评分(HSS)、胫骨后倾角(PTS)水平高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后3个月,两组Insall-Salvati指数(ISI)、Caton-Deschamps指数(CDI)及Blackburn-Peel指数(BPI)均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。结论:相较于UKA,膝关节内侧间室骨关节炎患者采用OWHTO治疗,虽其手术时间、住院时间与术中出血量均更大,但可有效降低患者疼痛度,明显促进膝关节功能恢复,获得显著的疗效。

Objective:To compare the effect of open wedge high tibial osteotomy(OWHTO)and unicompartmental knee arthroplasty(UKA)in the treatment of patients with medial compartment osteoarthritis of the knee.Method:A total of 110 patients with medial compartmental knee osteoarthritis who admitted to Shijiazhuang Third Hospital from April 2019 to April 2022 were selected as the research objects,they were divided into the control group and the observation group according to the random number table,55 cases in each group.The control group was treated with UKA,and the observation group was treated with OWHTO.The operation related indexes,visual analogue scale(VAS)score,knee joint function,maximum angle of knee flexion and patella height before and 3 months after operation were compared between two groups.Result:The operation time and hospitalization time in the observation group were longer than those in the control group,and the amount of bleeding during operation was more than that in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in VAS score,knee joint function,maximum knee flexion angle and patella height between two groups(P>0.05);at 3 months after operation,the VAS score and femurtibia angle(FTA)of two groups were lower than those before operation,and which of the observation group were lower than those of the control group,the Hospital for Special Surgery knee score(HSS)and posterior tibial slope(PTS)of two groups were higher than those before operation,and which of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05);at 3 months after operation,the Insall-Salvati index(ISI),Caton-Deschamps index(CDI)and Blackburn-Peel index(BPI)of two groups were lower than those before operation,but those of the observation group were higher than those of the control group,the differences were significant(P<0.05).Conclusion:Compared with UKA,patients with medial compartmental knee osteoarthritis treated with OWHTO,although the operation time,hospitalization time and intraoperative blood loss are larger,but it could effectively reduce the pain of patients,significantly promote the recovery of knee joint function,and obtain significant curative effect.