摘要
背景：近年来随着假体材料的改进、聚乙烯衬垫的增厚、手术适应证的合理选择以及手术技巧的熟练,单髁置换术（UKA）的临床疗效逐渐提高,可以媲美全膝置换术（TKA）,甚至优于全膝置换术,但是目前UKA还未被广泛接受。目的目的：探讨UKA和TKA治疗膝内侧单间室骨关节炎的近期临床疗效。方法：选取2014年12月至2015年12月在广东省中医院关节科行膝关节牛津单髁置换术和全膝关节置换术治疗的患者各35例。单髁治疗组：男10例（10膝）,女25例（25膝）;平均年龄66岁（58-77岁）;平均体重66 kg（48-90 kg）;术后平均随访8.8个月（3-14个月）。全膝治疗组：男12例（12膝）,女23例（23膝）;平均年龄65.5岁（52-79岁）;平均体重66.5 kg（48-90 kg）;术后平均随访12.8个月（7-14个月）。全部病例均由同一主刀医师完成。对两组患者失血量、负压引流量、膝关节屈曲90°所需时间、并发症、住院时间及住院费用进行评估。手术前后均采用纽约特种外科医院膝关节评分（HSS评分）对两组患者关节活动度、关节功能进行评价。结果结果：两组膝关节屈曲90°所需时间、术中出血量、关节负压引流量、术后第3天血红蛋白下降水平、住院平均费用比较,差异均有统计学意义（P〈0.001）;住院天数比较,差异有统计学意义（P〈0.05）。两组患者术后均未出现假体松动,关节翻修等并发症,疗效满意。结论结论：在严格掌握适应证的前提下,对于膝内侧单间室骨关节炎患者的手术治疗,UKA与TKA均能够有效缓解患者痛苦,改善膝关节功能,而且UKA与TKA比较,具有失血量少、负压引流量少,膝关节功能恢复快,创伤小,康复快,住院时间短,费用少等优点。
Background： In recent years,with the development of prosthetic materials,the thickening of polyethylene liner,the rational choice of patients and the improvement of surgical technique,the clinical effect of unicompartmental knee arthroplasty（UKA） has been gradually increasing,which is comparable to total knee arthroplasty（TKA）,even better than TKA,but UKA is still not popular. Objective： To compare the early clinical outcome between UKA and TKA for the treatment of isolated compartmental osteoarthritis of the knee. Methods： Seventy patients with isolated compartmental osteoarthritis of the knee treated by UKA or TKA in the Guangdong Provincial Hospital of TCM between December 2014 and December 2015 were enrolled in this retrospective study. In UKA group,there were 10 males（10 knees） and 25 females（25knees） with an average age of 66 years old（range,58-77 years）; the average body weight was 66 kg（range,48-90 kg）; the average follow-up period was 8.8 months（range,3-14 months）. In TKA group,there were 12 males（12 knees） and 23 females（23 knees） with an average age of 65.5 years old（range,52-79 years）; the average body weight was 66.5 kg（range,48-90 kg）; the average follow-up period was 12.8 months（range,7-14 months）. All the operations were performed by one doctor. Some parameters including blood loss,drainage,the time when the knee flexion can reach to 90 degree,complications,hospital stays and hospitalization costs were compared between two groups. The range of motion of the knee and joint function were evaluated by HSS score before and after operation. Results： There were significant differences in terms of the time when the knee flexion can reach to 90 degree,intraoperative blood loss,drainage,increased level of hemoglobin on the day 3 after surgery,and hospitalization costs between the two groups（P〈0.001）. So was the hospital stay（P〈0.05）. No loosening or revision happened in either group. The therapeutic effects of both groups appeared excellen
出处
《中国骨与关节外科》
2016年第6期476-479,503,共5页
Chinese Journal of Bone and Joint Surgery
关键词
单髁置换术
全膝关节置换术
膝骨关节炎
Unicompartmental Knee Arthroplasty
Total Knee Arthroplasty
Knee Osteoartheitis
