摘要
[目的]比较单髁膝置换(unicompartmental knee arthroplasty, UKA)和全膝置换(total knee arthroplasty, TKA)的早期临床效果与炎性指标变化。[方法]回顾性分析2017年1月~2018年12月,关节置换治疗膝内侧间室骨性关节炎96例患者的临床资料,其中,49例行UKA,47例行TKA。比较两组患者早期临床效果与术后早期C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin, PCT)和红细胞沉降率(erythrocyle sedimentation rate, ESR)的变化。[结果]两组患者均顺利手术,均未发生感染。UKA组手术时间、切口长度、术中失血量、术后引流量均显著优于TKA组(P<0.05)。末次随访时两组患者的VAS、KSS评分和膝伸屈ROM均较术前显著改善(P<0.05),但是相应时间点两组间上述指标的差异均无统计学意义(P>0.05)。炎性指标检测方面,两组CRP术后1 d开始上升,术后3 d时达到峰值,而后下降(P<0.05),但术后1 d、3 d和6 d时UKA组的CRP均显著低于TKA组(P<0.05)。两组患者PCT术后1 d显著上升,而后下降(P<0.05);术后1 d时UKA组的PCT显著低于TKA组(P<0.05)。术前至术后6 d,两组患者的ESR均随时间推移而持续增加,相应时间点,两组间ESR的差异均无统计学意义(P>0.05)。[结论]与TKA相比,UKA治疗内侧间室骨性关节炎的手术创伤更小。相较于PCT和ESR,CPR可更好地反映机体对手术的反应。
[Objective] To compare the early clinical results and inflammatory index changes of unicompartmental knee arthroplasty(UKA) versus total knee arthroplasty(TKA). [Methods] A retrospective study was done on 96 patients who received knee arthroplasty for medial compartment knee osteoarthritis in our department from January 2017 to December 2018. Among them, 49 patients underwent UKA and 47 patients had TKA performed. The two groups were compared regarding early clinical outcomes, as well as changes in C-reactive protein(CRP), procalcitonin(PCT) and erythrocyte sedimentation rate(ESR) in the early postoperative period. [Results] The patients in both groups were successfully operated without infection. The UKA group was significantly superior to the TKA group in terms of operation time,incision length, intraoperative blood loss and postoperative drainage(P<0.05). At the last follow-up the VAS scores, KSS scores, and knee extension-flexion ROM of the two groups were significantly improved compared with those before surgery(P<0.05), whereas the differences in the above indicators between the two groups at the corresponding time points were not statistically significant(P>0.05). In terms of inflammatory item detection, the CRP in both groups began to rise at 1 day after surgery, reached the peak at 3 days postoperatively, and then decreased(P<0.05), while which in the UKA group was significantly lower than the TKA group at 1, 3 and 6 days after operation(P<0.05).The PCT increased significantly at 1 day after surgery, and then decreased in both groups(P<0.05), which the proportion of PCT increased in the UKA group was significantly lower than that of the TKA group at 1 day after operation(P<0.05). From the day preoperatively to 6 days postoperatively, the ESR in the two groups continued to increase over time(P<0.05), whereas without significant difference in ESR between the two groups at any corresponding time point(P>0.05). [Conclusion] UKA has less surgical trauma than the TKA for medial compartment osteoarthritis. The
作者
薛军
任忠明
吴鹏
申世源
魏海清
吴成
谢国庆
XUE Jun;REN Zhong-ming;WU Peng;SHEN Shi-yuan;WEI Hai-qing;WU Cheng;XIE Guo-qing(Department of Joint Surgery,Maritime Police Hospital,Jiaxing 314100,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第5期418-422,共5页
Orthopedic Journal of China
基金
浙江省嘉兴市公益性研究计划项目(编号:2019AD32215)。
关键词
膝内侧室骨性关节炎
单髁膝置换
全膝置换
C反应蛋白
medial compartment knee osteoarthritis
unicompartmental knee arthroplasty
total knee arthroplasty
C-reactive protein
