单髁或全膝置换术治疗膝内侧间室骨关节炎的早期疗效对比

Early Clinical Result Comparison of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty for Medial Compartment Osteoarthritis of the Knee

目的对比分析单髁置换术(unicompartmental knee arthroplasty,UKA)与全膝关节置换术(total knee arthroplasty,TKA)治疗膝内侧间室骨关节炎(knee osteoarthritis,KOA)的疗效。方法回顾性分析2019年1月至2021年9月新乡医学院第一附属医院收治的78例膝关节内侧单间室骨关节炎患者,按手术方式分为UKA组和TKA组。UKA组39例患者,其中男7例,女32例;年龄45~74岁,平均(63.4±7.9)岁;身体质量指数(body mass index,BMI)为(25.92±2.70)kg/m~2。TKA组39例患者,其中男12例,女27例;年龄53~76岁,平均(65.8±6.3)岁;BMI为(26.61±4.07)kg/m~2。比较两组手术时间、术中出血量、总住院时长、术后引流量、疼痛视觉模拟评分(visual analogue scale,VAS)、膝关节活动度(range of motion,ROM)和纽约特种外科医院(the hospital for special surgery,HSS)膝关节评分及人工关节遗忘评分(forgotten joint scores,FJS)。结果78例患者均获得随访,随访时间12~16个月,平均随访(14.1±1.1)个月。UKA组手术时间、住院总时长、手术切口长度、术中出血量、术后引流量均少于TKA组,差异均有统计学意义(P<0.05)。两组患者术前VAS、ROM、HSS评分比较差异无统计学意义(P>0.05);术后3、6、12个月,UKA组患者VAS、HSS评分及ROM均优于TKA组,差异均有统计学意义(P<0.05)。术后3、6、12个月,UKA组患者FJS评分均高于TKA组,差异均有统计学意义(P<0.05)。结论UKA与TKA治疗内侧单间室KOA,均可明显缓解膝关节疼痛,改善膝关节功能;相较TKA,UKA具有创伤小、恢复快、患者关节忘却程度高等优势。

Objective To compare and analyze the effectiveness of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of osteoarthritis of the knee in the medial compartment.Methods A retrospective analysis was conducted on 78 patients with the knee osteoarthritis(KOA)in the medial compartment who were admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2019 to September 2021.The patients were divided into the UKA and TKA groups according to the surgical method.There were 39 patients in the UKA group,including 7 males and 32 females.The patients’age ranged from 45 to 74 years,with an average of(63.4±7.9)years.And the body mass index(BMI)was(25.92±2.70)kg/m 2.There were 39 patients in the TKA group,including 12 males and 27 females.The patients’age ranged from 53 to 76 years,with an average age of(65.8±6.3)years,and the BMI was(26.61±4.07)kg/m 2.The surgical time,intraoperative blood loss,total hospital stay,postoperative drainage volume,visual analogue scale(VAS)pain score,range of motion(ROM)of the knee joint,the hospital for special surgery(HSS)knee score,and the forgotten joint scores(FJS)were compared between the two groups.Results The follow-up time was 12 to 16 months,with a mean of(14.1±1.1)months.The UKA group had significantly less surgical time,total hospital stay,surgical incision length,intraoperative blood loss,and postoperative drainage volume than the TKA group(P<0.05).There was no statistically significant difference in preoperative VAS,ROM,and HSSs between the two groups(P>0.05).However,the postoperative 3,6 and 12 months VAS,HSS,and ROM scores of the UKA group were superior to those of the TKA group(P<0.05).The postoperative 3,6,and 12 months FJS scores of the UKA group were also higher than those of the TKA group,with statistical significance(P<0.05).Conclusion Both UKA and TKA can significantly relieve knee joint pain and improve knee joint function in the treatment of medial compartment KOA.Compared with TKA,UKA has the advantages of being less invasive,faster recovery,and less noticeable sensation of the prosthesis after surgery.