摘要
目的:探讨Oxford第3代混合型单髁置换(unicompartmental knee arthroplasty,UKA)与全膝关节置换(total knee arthroplasty,TKA)治疗膝关节内侧间室骨关节炎的疗效。方法:回顾性分析2017年10月至2019年10月行膝关节置换术的156例患者,男44例,女112例,年龄50~75(58.76±4.97)岁。根据不同治疗方式分为单侧TKA组和单侧Oxford第3代混合型UKA组。单侧TKA 81例(81膝),男23例,女58例,年龄51~75(58.60±5.01)岁;单侧Oxford第3代混合型UKA 75例(75膝),男21例,女54例,年龄50~72(58.92±4.95)岁。比较两组临床评估指标,包括手术一般情况、相关并发症、美国膝关节协会评分(American Knee Society score,AKSS)临床评分和功能评分;影像评估指标包括髋膝踝角(hip-knee-ankle angle,HKA)、股骨假体内外翻角(femoral component valgus/varus angle,FCVA)、股骨假体后倾角(femoral component posterior slope angle,FCPSA)、胫骨假体内外翻角(tibial component valgus/varus angle,TCVA)、胫骨假体后倾角(tibial component posterior slope angle,TCPSA),是否发生膝关节外侧间室进展、衬垫脱位、假体下沉、松动。结果:UKA组术中出血量、手术时间、住院天数均显著优于TKA组(P<0.05),两组术后均未出现并发症。两组患者均获随访,时间24~54(38.01±8.90)个月。末次随访两组AKSS临床评分、功能评分、HKA均优于术前(P<0.05)。末次随访UKA组AKSS临床评分、功能评分均优于TKA组(P<0.05),TKA组HKA优于UKA组(P<0.05)。末次随访两组TCVA、FCVA差异无统计学意义(P>0.05),UKA组TCPSA、FCPSA大于TKA组(P<0.05),UKA组未出现外侧室进展。结论:Oxford第3代混合型UKA治疗膝关节内侧间室骨关节炎,较TKA具有手术创伤小、失血量少、手术时间短、住院时间短、术后快速康复、膝关节功能恢复更好等优势,疗效满意。
Objective To evaluate outcomes of mixed unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of medial osteoarthritis(OA)of the knee.Methods Retrospective analysis of 156 patients,44 males and 112 females,aged from 50 to 75 years old with an average of(58.76±4.97)years old,who underwent knee arthroplasty from October 2017 to October 2019.The patients were divided into two groups:81 cases(81 knees)underwent TKA,including 23 males and 58 females,aged from 51 to 75 years old with an average of(58.60±5.01)years old,and 75 case(75 knees)underwent UKA with mixed phase 3 Oxford,including 21 males and 54 females,aged from 50 to 72 years old with an average of(58.92±4.95)years old.The two groups were compared regarding to the clinical outcomes,assessed using surgical information and complications,American Knee Society score(AKSS)clinical score and functional score.Radiographs were assessed using hip-knee-ankle angle(HKA),tibial component valgus/varus angle(TCVA),tibial component posterior slope angle(TCPSA),femoral component valgus/varus angle(FCVA),femoral component posterior slope angle(FCPSA),looking for bearing dislocation,prosthesis loosening,progression of OA in lateral compartment.Results Intraoperative bleeding,operative time and hospital days were significantly better in the UKA group than in the TKA group(P<0.05),and there were no postoperative complications in either group.Patients in both groups were enrolled with an average follow-up time of(38.01±8.90)months,ranged from 24 to 54 months.AKSS functional,AKSS clinical,HKA in both groups significantly improved at the final follow-up compared with those before operation.At the final follow-up,the UKA group was significantly better than the TKA group in AKSS functional and AKSS clinical,whereas HKA in the TKA group was better.At the final follow-up.TCVA and FCVA between the two groups were not significantly different,while TCPSA and FCPSA in the UKA group were significantly greater than the TKA group.No signs of progression o
作者
许志庆
庄至坤
龚志兵
吴荣凯
徐福东
XU Zhi-qing;ZHUANG Zhi-kun;GONG Zhi-bing;WU Rong-kai;XU Fu-dong(Department of Joint Surgery,Quanzhou Orthopedics Hospital,Quanzhou 362000,Fujian,China)
出处
《中国骨伤》
CAS
CSCD
2023年第6期507-513,共7页
China Journal of Orthopaedics and Traumatology
