固定与活动平台单髁置换术的近期结果比较
Short-term outcomes of fixed-bearing unicompartmental knee arthroplasty versus mobile bearing counterpart for medial knee osteoarthritis
臧伟 1王建华 1刘宇航 1张全彬2
作者信息
- 1. 天津市泰达医院骨科,天津 300457
- 2. 淄博市中心医院创伤骨科,山东淄博 255000
- 折叠
摘要
[目的]比较固定平台单髁置换(fixed-bearing unicompartmental knee arthroplasty,FB-UKA)与活动平台单髁置换(mobile-bearing unicompartmental knee arthroplasty,MB-UKA)治疗膝关节内侧间室骨关节炎的临床疗效.[方法]回顾性分析2020年1月-2023年2月采用UKA治疗的98例膝关节内侧间室骨关节炎患者的临床资料.根据医患沟通结果,43例采用FB-UKA,使用Zimmer假体;另外55例采用MB-UKA,使用Oxford假体.比较两组围手术期、随访及影像结果.[结果]所有患者均顺利完成手术,两组手术时间、切口长度、术中失血量、下地行走时间、切口愈合等级、住院时间、治疗费用的差异均无统计学意义(P＞0.05).随访时间平均(12.7±4.8)个月.两组完全负重活动时间的差异无统计学意义(P＞0.05),术后两组患者VAS、WOMAC评分均显著减少(P＜0.05),HSS、FJS评分及膝伸-屈ROM均显著增加(P＜0.05).末次随访时,MB组的关节遗忘评分(forgotten joint score,FJS)[(85.5±3.5)vs(84.1±2.7),P=0.032]、膝伸-屈 ROM[(125.4±3.5)° vs(123.7±4.2)°,P=0.031]显著优于FB组.影像方面,术后两组HKAA、JICA均显著改善(P＜0.05),TPVA无显著变化(P＞0.05).相应时间点,两组间上述影像指标的差异均无统计学意义(P＞0.05).[结论]对于内侧室膝骨性关节炎,MB-UKA术后近期关节遗忘评分优于FB-UKA.
Abstract
[Objective]To compare the short-term clinical outcomes of fixed-bearing unicompartmental knee arthroplasty(FB-UKA)verus mobile bearing unicompartmental knee arthroplasty(MB-UKA)for medial knee osteoarthritis.[Methods]A retrospective study was conducted on 98 patients who received UKA for medial knee osteoarthritis from January 2020 to February 2023.According to the results of doctor-patient communication,43 underwent FB-UKA with Zimmer prosthesis,while other 55 patients were treated with MB-UKA by using Oxford prosthesis.The data of perioperative period,follow-up and images were compared between the two groups.[Results]All patients in both groups had UKA performed successfully without statistically significant differences in operation time,incision length,intraoperative blood loss,ambulation time,incision healing grade,hospital stay and hospital cost between the two groups(P＞0.05).All of them in both groups were followed up for(12.7±4.8)months in an average,and there was no significant difference in the time to regain full weight-bearing activities between the two groups(P＞0.05).The VAS and WOMAC scores significantly decreased(P＜0.05),while HSS score,forgotten joint score(FJS)and knee extension-flexion ROM significantly increased in both groups at the latest follow-up compared with those preoperative-ly(P＜0.05).At the last follow-up,the MB group was significantly better than the FB group in terms of FJS[(85.5±3.5)vs(84.1±2.7),P=0.032],and knee extension-flexion ROM[(125.4±3.5)° vs(123.7±4.2)°,P=0.031].As for imaging,HKAA and JICA were significantly im-proved in both groups after surgery(P＜0.05),while TPVA remained unchanged significantly(P＞0.05).At corresponding time points,there were no significant differences in the above imaging items between the two groups(P＞0.05).[Conclusion]For medial knee osteoarthritis,the MB-UKA has better forgotten joint score regarding to short-term clinical consequence over the FB-UKA.
关键词
膝/骨关节炎/单髁置换术/关节遗忘评分Key words
knee/osteoarthritis/unicompartmental knee arthroplasty/forgotten joint score引用本文复制引用
出版年
2024
NETL
NSTL
万方数据