摘要
[目的]分析单髁置换是否联合术中髌骨去神经化治疗膝关节骨关节炎的疗效差异。[方法]回顾性分析2022年1月—2024年1月80例采用单髁置换治疗的膝关节骨关节炎患者的临床资料。根据术前医患沟通结果,42例采用单髁置换联合术中髌骨去神经化(去神经组),另外38例采用常规单髁置换(未去神经组)。比较围术期、临床及影像结果。[结果]去神经组手术时间、切口总长度、术中失血量高于未去神经组(P<0.05),两组下地行走时间、住院时间、切口愈合等级、并发症总发生率差异无统计学意义(P>0.05)。去神经组恢复完全负重时间显著早于未去神经组[d,(30.2±5.6)vs(34.4±5.3),P=0.001]。随时间推移,两组VAS评分、HSS评分、屈-伸ROM均逐渐改善(P<0.05)。术后3个月去神经组的VAS评分[分,(2.3±0.3)vs(2.7±0.6),P=0.001]、HSS评分[分,(83.5±4.6)vs(79.8±4.4),P<0.001]和屈-伸ROM[°,(112.3±7.6)vs(105.3±7.0),P<0.001]均显著优于未去神经组。影像方面,与术前相比,末次随访时两组FTA、HKA、MPTA、MAD和PTS均逐渐改善(P<0.05),但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]单髁置换联合术中髌骨去神经化治疗膝关节骨关节炎能够降低术后近期疼痛症状,改善关节功能,但术中会增加手术时间,延长手术切口长度。
[Objective]To compare the clinical efficacy of medial unicompartmental knee arthroplasty(UKA)with or without patellar denervation for medial knee osteoarthritis.[Methods]A retrospective study was done on 80 patients who had medial knee osteoarthritis treated with UKA from January 2022 to January 2024.According to preoperative doctor-patient communication,42 patients received UKA combined with patellar denervation(denervation group),while the other 38 patients underwent conventional UKA only without patellar de⁃nervation(non-denervation group).The perioperative,clinical and imaging results were compared.[Results]The denervation group was sig⁃nificantly greater than the non-denervation group in terms of operation time,total incision length and intraoperative blood loss(P<0.05),de⁃spite of the fact that no statistically significant differences were noted in the ambulation time,hospital stay,incision healing grade and total incidence of complications between the two groups(P>0.05).The denervation group recovered full weight-bearing significantly earlier than the non-denervation group[d,(30.2±5.6)vs(34.4±5.3),P=0.001].The VAS,HSS scores,flexion-extension ROM significantly improved in both groups over time(P<0.05).The denervation group were significantly better than the non-denervation group in terms of the VAS[score,(2.3±0.3)vs(2.7±0.6),P=0.001],HSS[score,(83.5±4.6)vs(79.8±4.4),P<0.001]and flexion-extension ROM[°,(112.3±7.6)vs(105.3±7.0),P<0.001]3 months after surgery.As for imaging,the FTA,HKA,MPTA,MAD and PTS of both groups significantly improved at the last fol⁃low-up compared with those preoperatively(P<0.05),whereas which were not statistically significant between the two groups at any corre⁃sponding time points(P>0.05).[Conclusion]UKA combined with patellar denervation for medial knee osteoarthritis can reduce the short-term postoperative pain symptoms and improve joint function,but it will increase the operation time and prolong the surgical incision.
作者
连怡钧
李清江
崔明星
赵斌
LIAN Yi-jun;LI Qing-jiang;CUI Ming-xing;ZHAO Bin(Department of Joint Surgery and Sports Medicine,The First Affiliated Hospital,Xinxiang Medical University,Xinxiang453000,Henan,China)
出处
《中国矫形外科杂志》
北大核心
2026年第4期325-330,共6页
Orthopedic Journal of China
关键词
膝关节骨关节炎
疼痛
单髁置换
术中髌骨去神经化
关节功能
knee osteoarthritis
pain
unicompartmental knee arthroplasty
patellar denervation
joint function
