单髁置换术与全膝关节置换术治疗膝骨关节炎的早期疗效评价

Early Efficacy Evaluation of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis

目的评价单髁置换术(UKA)与全膝关节置换术(TKA)治疗膝骨关节炎的早期疗效差异。方法纳入2020年6月-2022年2月于新疆生产建设兵团第六师奇台医院就诊的符合手术治疗的膝骨关节炎患者77例,按照治疗方式不同分为UKA组(n=35)和TKA组(n=42)。UKA组予以UKA,TKA组予以TKA,比较两组临床指标(手术时间、术中出血、术后引流量、住院时间)、膝关节疼痛及活动度[疼痛视觉模拟评分(VAS)、膝关节活动度(ROM)]、预后(WOMAC评分)、经济负担。结果UKA组手术时间、住院时间短于TKA组,术中出血、术后引流量少于TKA组,但差异无统计学意义(P>0.05);两组术后VAS评分低于术前,ROM高于术前,且UKA组VAS评分、ROM低于TKA组,差异有统计学意义(P<0.05);两组术后1周及1、3、6、12个月WOMAC评分低于术前,且UKA组术后3个月WOMAC评分低于TKA组,差异有统计学意义(P<0.05);UKA组术后总费用评分低于TKA组,其中材料费UKA组低于TKA组,差异有统计学意义(P<0.05)。结论UKA术式在早期缓解膝骨关节炎患者疼痛、降低WOMAC评分、减轻经济负担方面具有更好的优势,而TKA术式能更好地恢复患者膝关节活动度,因此临床上应综合评价患者预后的差异及经济条件后再选择适宜的手术方式。

Objective To evaluate the early efficacy of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of knee osteoarthritis.Methods From June 2020 to February 2022,77 patients with knee osteoarthritis who met the surgical treatment in Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps were included.According to different treatment methods,they were divided into UKA group(n=35)and TKA group(n=42).UKA group was treated with UKA,and TKA group was treated with TKA.The clinical indexes(operation time,intraoperative bleeding,postoperative drainage volume,hospitalization time),knee joint pain and activity[Visual Analogue Scale(VAS),range of motion(ROM)],prognosis(WOMAC score)and economic burden were compared between the two groups.Results The operation time and hospitalization time of UKA group were shorter than those of TKA group,and the intraoperative bleeding and postoperative drainage volume were less than those of TKA group,but the differences were not statistically significant(P>0.05).The VAS score of the two groups after operation was lower than that before operation,and the ROM was higher than that before operation,while the VAS score and ROM of the UKA group were lower than those of the TKA group,and the differences were statistically significant(P<0.05).The WOMAC score of the two groups at 1 week,1 month,3 months,6 months and 12 months after operation was lower than that before operation,and the WOMAC score of the UKA group at 3 months after operation was lower than that of the TKA group,the differences was statistically significant(P<0.05).The total cost score of the UKA group was lower than that of the TKA group,and the material cost of the UKA group was lower than that of the TKA group,the difference was statistically significant(P<0.05).Conclusion UKA has better advantages in relieving pain,reducing WOMAC score and reducing economic burden in patients with knee osteoarthritis in the early stage,while TKA can better restore the knee joint activity of patients.Therefore,the difference of prognosis and economic conditions of patients should be comprehensively evaluated before selecting the appropriate surgical method.