摘要
目的 比较胫骨高位截骨术(HTO)与单髁置换术(UKA)治疗膝关节单侧骨性关节炎(OA)的临床效果.方法 选取2018年10月至2022年10月于三门峡市中心医院住院治疗的94例膝关节单侧OA患者为研究对象.根据治疗方法分为A组与B组,A组38例患者行HTO治疗,B组56例患者行UKA治疗.两组术后均随访1年.比较两组临床相关指标、疼痛视觉模拟评分(VAS)评分、膝关节功能[胫骨角(FTA)、膝关节活动度(ROM)、美国特种外科医院评分量表(HSS)]、术后并发症等指标.结果 B组手术时间、术后下床时间、住院时间均短于A组,差异有统计学意义(P＜0.05);但两组术中出血量及术后引流量比较,差异未见统计学意义(P＞0.05).术前,两组日常活动VAS评分及爬楼梯VAS评分比较差异未见统计学意义(P＞0.05);术后1周及术后1年,两组日常活动VAS评分及爬楼梯VAS评分均较术前降低(P＜0.05),但组间比较,差异未见统计学意义(P＞0.05).术前,两组FTA、ROM、HSS评分及Lysholm评分比较差异未见统计学意义(P＞0.05);术后,两组FTA减少,ROM、HSS评分及Lysholm评分均增加,差异有统计学意义(P＜0.05);术后A组ROM大于B组,差异有统计学意义(P＜0.05);术后,两组FTA、HSS评分及Lysholm评分比较,差异未见统计学意义(P＞0.05).两组术后并发症发生率比较,差异未见统计学意义(P＞0.05).结论 HTO及UKA治疗膝关节单侧OA的效果均显著,UKA在缩短手术时间、促进术后康复方面效果更佳,而HTO在改善膝关节活动度方面具有优势;但对于术后疼痛评分和术后并发症发生率方面,两种手术治疗无明显差异.
Abstract
Objective To evaluate the clinical effects of high tibial osteotomy(HTO)and single condylar replacement(UKA)on unilateral knee osteoarthritis(OA).Methods Ninety-four patients with unilateral knee osteoarthritis who were hospitalized at Sanmenxia Central Hospital from October 2018 to October 2022 were selected as the research subjects.They were divided into group A and group B according to the treatment method,the 38 patients in group A received HTO treatment,while the 56 patients in group B received UKA treatment.Both groups were followed up for 1 year after surgery.The clinically relevant indicators,VAS scores,knee joint function[tibial angle(FTA),knee range of motion(ROM),and the American Special Surgery Hospital Rating Scale(HSS)],postoperative complications were compared between the two groups.Results The surgical time,postoperative time to get out of bed,and hospital stay in group B were all shorter than those in group A,and the differences were significant(P＜0.05);However,there was no significant difference in intraoperative bleeding volume and postoperative drainage volume between the two groups(P＞0.05).Before surgery,there was no significant difference in the VAS scores for daily activities and stair climbing between the two groups(P＞0.05).One week and one year after surgery,the VAS scores for daily activities and stair climbing in both groups decreased compared to preoperative levels(P＜0.05),but there was no significant difference between the two groups(P＞0.05).Before surgery,there was no significant difference in FTA,ROM,HSS scores,and Lysholm scores between the two groups(P＞0.05).After surgery,the FTA of the two groups decreased,while the ROM,HSS score,and Lysholm score increased,and the differences were significant(P＜0.05);the postoperative ROM in group A was higher than that in group B,and the difference was significant(P＜0.05);after surgery,there was no significant difference in FTA,HSS scores,and Lysholm scores between the two groups(P＞0.05).There was no significant difference in the incidence of postoperative complications between the two groups(x2=0.134,P=0.715＞0.05).Conclusions Both HTO and UKA have significant efficacy on unilateral OA of the knee joint.UKA is more effective on shortening operation time and promoting postoperative rehabilitation,while HTO has an advantage in improving knee joint motion.However,there was no significant difference in postoperative pain score and postoperative complication rate between the two surgical treatments.
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