摘要
目的探讨中重度膝关节前内侧骨关节炎运用单髁关节置换术后的疗效。方法选用2013年11月至2017年5月,由同一手术医生完成的单髁置换术治疗膝关节骨关节炎的1217例为研究对象,其中中重度肥胖组20例(27膝),非肥胖组21例(27膝)。术前、术后均采用HSS膝关节功能评分、疼痛视觉模拟评分(visual analogue scale,VAS),平均住院日、膝关节活动度等相关指标进行评估。结果肥胖组2例(3膝)失访,1例死亡;非肥胖组3例(3膝)患者术后失访,无死亡,其余患者均获得完整随访。肥胖组随访时间14～56个月,平均27个月;非肥胖组随访时间21～33个月,平均24个月。术前两组间HSS评分、VAS评分、膝关节活动度差异均无统计学意义(P>0.05),两组间患者的住院日差异无统计学意义(P>0.05)。末次随访时,两组间HSS评分、VAS评分、膝关节活动度差异均无统计学意义(P>0.05)。HSS评分:肥胖组术前(51.37±7.34)分,术后(91.30±4.91)分,差异有统计学意义(P<0.05);VAS评分:肥胖组术前(5.15±0.60)分,术后(1.11±1.05)分,差异有统计学意义(P<0.05);膝关节活动度:肥胖组术前(98.13±8.82)°,术后(114.29±8.40)°,差异有统计学意义(P<0.05)。肥胖组1例术后出现I型呼衰、双肺炎,左侧胸腔积液,经抗生素治疗,胸腔闭式引流治愈后出院;非肥胖组1例术后4周出现伤口浅表感染,经抗生素治疗愈后出院。其余患者未见翻修,假体周围感染、假体松动等术后并发症。结论仅限于单间室的膝关节骨关节炎合并中重度肥胖的患者,单髁关节置换,合理的围手术期管理,可达到满意的临床疗效。
Objective To explore short-term efficacy of unicondylar knee arthroplasty in the treatment of moderate-severely obese patients(BMI≥35)with anterior medial osteoarthritis of the knee.Methods From November 2013 to May 2017,1217 patients were selected as the study subjects.Among them,20 patients(27 knees)with moderate-severe obesity were included in the obese group,and 21 patients(27 knees)in the non-obese group.Both groups were evaluated using HSS knee function score,VAS pain score,the average hospital stay,knee joint activity and other related indicators before and after surgery.Results In the obese group,2 patients(3 knees)were lost and 1 patient died.In the non-obese group,3 patients(3 knees)were lost and none died.The rest of the patients were followed up completely.The obese group was followed up for 14-56 months with an average of 27 months.The nonobese group was followed up for 21-33 months with an average of 24 months.There were no statistically significant differences in HSS score,VAS score and knee activity between the 2 groups before surgery and at the last follow-up(P>0.05),as well as the hospital stay between the 2 groups(P>0.05).HSS score:(51.37±7.34)preoperatively and(91.30±4.91)postoperatively in the obese group with statistically significant differences(P<0.05).VAS score:(5.15±0.60)preoperatively and(1.11±1.05)postoperatively in the obese group with statistically significant differences(P<0.05).Knee range of motion:(98.13±8.82)preoperatively and(114.29±8.40)postoperatively in the obese group with statistically significant differences(P<0.05).Obese group:1 patient developed type I respiratory failure and double pneumonia after surgery;the left pleural effusion was observed;after antibiotic treatment,the patient was discharged after thoracic closed drainage.Non-obese group:1 patient was discharged from the hospital after antibiotic treatment of superficial infection of the wound 4 weeks after surgery.Other patients had no postoperative complications such as renovations,periprosthetic infectio
作者
王方兴
薛华明
马童
文涛
杨涛
涂意辉
WANG Fang-xing;XUE Hua-ming;MA Tong;WEN Tao;YANG Tao;TU Yi-hui(Department of Joint Surgery,Yangpu Hospital affiliated to Tongji University,Shanghai,200082,China)
出处
《中国骨与关节杂志》
CAS
2019年第4期249-254,共6页
Chinese Journal of Bone and Joint
关键词
关节成形术
置换
膝
肥胖症
骨关节炎
膝
膝关节
Arthroplasty,replacement,knee
Obesity
Osteoarthritis,knee
Knee joint
