摘要
目的探讨单髁置换术(UKA)与微创全膝关节置换术(MIS-TKA)治疗老年膝关节骨性关节炎的临床效果。方法将64例老年膝关节骨性关节炎患者随机分为UKA组和MIS-TKA组,每组32例。观察两组手术前后疼痛VAS和HSS评分、术后直腿抬高和主动屈曲到90°所用的时间、膝关节活动度及并发症情况。结果患者均获得12个月的随访。术后12个月VAS评分和HSS评分:UKA组分别为(2.34±0.84)分和(82.37±6.93)分,MIS-TKA组分别为(2.41±0.87)分和(82.42±6.89)分,两组各项评分均较术前明显改善(P<0.05),组间比较差异无统计学意义(P>0.05)。UKA组患者直腿抬高及主动屈曲到90°所用时间均明显少于MIS-TKA组患者(P<0.001)。膝关节活动度:术后1、3、6个月UKA组均明显优于MIS-TKA组(P<0.05);术后12个月时两组比较差异无统计学意义(P>0.05)。除了MIS-TKA组出现1例膝关节感染外,两组均未出现假体松动、皮肤坏死、深部感染及深静脉血栓等并发症。结论 UKA与MIS-TKA治疗老年膝关节骨性关节炎均能够有效恢复患者膝关节功能,但UKA具有术后患者恢复快、并发症少等优点。
Objective To investigate the clinical effect of unicompartment knee arthroplasty（ UKA） and minimal invasive total knee arthroplasty（ MIS-TKA） for treatment of elderly knee osteoarthritis Methods The 64 elderly patients with knee osteoarthritis were randomly divided into UKA group and MIS-TKA group,with 32 cases in each group. The pre-and post-operative VAS and HSS scores,the time of straight leg elevation and active flexion to 90°,knee motion and complications were observed. Results All patients were followed up for 12 months. At 12 months after operation,the VAS and HSS score were 2. 34 ± 0. 84 and 82. 37 ± 6. 93,respectively. The scores of MIS-TKA group were 2. 41 ± 0. 87 and 82. 42 ± 6. 89,respectively. There were no significant differences between the two groups（ P 0. 05）. The time of straight leg elevation and active flexion to 90° in the MIS-TKA group was significantly less than that in the MIS-TKA group（ P 0. 05）. There was no significant difference at 12 months after operation（ P 0. 05）. Except one case of knee joint infection in MIS-TKA group,there were no complications such as loosening of prosthesis,skin necrosis,deep infection and deep vein thrombosis in both groups. Conclusions Both UKA and MIS-TKA can effectively recover the knee joint function of the elderly patients with osteoarthritis,but the UKA has the advantages of quick recovery and less complications.
作者
黎文勇
林炳基
LI Wen-yong, LIN Bing-ji(Dept of Orthopaedics, Chancheng Central Hospital of Foshan, Guangdong 528000, China)
出处
《临床骨科杂志》
2018年第4期466-469,共4页
Journal of Clinical Orthopaedics
关键词
单髁置换术
微创全膝关节置换术
膝关节骨性关节炎
unicompartment knee arthroplasty
minimally invasive total knee arthroplasty
knee osteoarthritis
