首页|两种置换术治疗老年女性内侧间室膝骨关节炎的疗效比较

两种置换术治疗老年女性内侧间室膝骨关节炎的疗效比较

Comparison effect of two kinds of arthroplasty for treatment of medial compartment osteoar-thritis in the elderly female patients

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目的 比较单髁关节置换术(UKA)和全膝关节置换术(TKA)治疗老年女性内侧间室膝骨关节炎(KOA)的临床疗效.方法 将87 例老年女性内侧间室KOA患者根据治疗方法不同分为TKA组(44 例)和UKA组(43 例).记录手术时间、术中出血量、术后引流量、屈曲 90°所需时间及住院时间,测量膝关节活动度,采用疼痛VAS评分评估膝关节疼痛情况,采用HSS 评分评价患肢功能,采用OKS评分评价患者术后满意度.结果 患者均获得12 个月随访.手术时间两组比较差异无统计学意义(P>0.05).术中出血量、术后引流量、住院时间、膝关节屈曲90°所需时间UKA组均少(短)于TKA组(P<0.05).HSS评分和疼痛VAS评分两组术后1、3、12 个月均优于术前(P<0.05),术后各时间段两组比较差异均无统计学意义(P>0.05).末次随访时,膝关节屈曲活动度两组比较差异无统计学意义(P>0.05);OKS评分UKA组高于TKA组(P<0.01).结论 UKA与TKA治疗KOA均能够有效改善患者膝关节功能,但UKA手术创伤小,出血量少,住院时间短,膝关节活动度恢复好,患者满意度高.
Objective To compare the clinical effects of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)for treatment of medial compartment knee osteoarthritis(KOA)in the elderly female patients.Methods The 87 elderly female KOA patients were divided into TKA group(44 cases)and UKA group(43 cases)according to different treatment methods.Surgical duration,intraoperative bleeding loss volume,postoperative drainage volume,the needing time of knee flexing to 90° and length of hospital stay were recorded.Knee joint mobility was measured.Pain visual analogue scale(VAS)and new York Special Surgery Hospital(HSS)score were used to evalu-ate knee pain status and affected limb function,and Oxford Knee Score(OKS)was used to assess the postoperative satisfaction.Results All patients were followed up for 12 months.There was no statistical difference in the surgical duration between the two groups(P>0.05).The volume of intraoperative blood loss,postoperative drainage volume,length of hospital stay and the time required to flex 90° of knee joint in UKA group were less(shorter)than those in TKA group(P<0.05).The HSS scores and pain VAS:at 1,3,and 12 months postoperation,they were better than the preoperation in both groups(P<0.05),and there were all no statistical differences between two groups at various point-time(P>0.05).At the final follow-up,there was no statistical difference in knee flexion range between the two groups(P>0.05);the OKS in the UKA group was higher than that in the TKA group(P<0.01).Conclusions Both UKA and TKA are effective in improving knee joint function in patients with KOA.However,UKA offers the ad-vantages of less surgical trauma and blood loss,shorter hospital stay,better knee joint mobility recovery,and higher pa-tients′satisfaction.

knee osteoarthritisunicompartmental knee arthroplastytotal knee arthroplastythe agedfemale

李翔、干开丰、潘凌霄

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宁波大学附属李惠利医院(宁波市医疗中心)关节与运动 医学科,浙江 宁波 315040

膝骨关节炎 单髁关节置换术 全膝关节置换术 老年人 女性

浙江省宁波市卫生健康委医学重点学科建设项目浙江省宁波市卫生健康委公益类科技项目

2022-B012021S105

2024

临床骨科杂志
安徽医科大学,安徽省医学会

临床骨科杂志

CSTPCD
影响因子:1.438
ISSN:1008-0287
年,卷(期):2024.27(2)
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