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[1]郭馬瓏,崔宏勛,李峰,等.單髁置換術治療中重度膝關節(jié)單間室骨關節(jié)炎[J].中醫(yī)正骨,2017,29(06):16-19,27.
　GUO Malong,CUI Hongxun,LI Feng,et al.Unicondylar knee arthroplasty for treatment of moderate-to-severe unicompartmental knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(06):16-19,27.
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單髁置換術治療中重度膝關節(jié)單間室骨關節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年06期
頁碼:
16-19,27
欄目:
臨床研究
出版日期:
2017-06-20

文章信息/Info

Title:
Unicondylar knee arthroplasty for treatment of moderate-to-severe unicompartmental knee osteoarthritis
作者:
郭馬瓏; 崔宏勛; 李峰; 郭珈宜; 姚俊娜; 米豫飛; 郭艷幸
河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002
Author(s):
GUO Malong; CUI Hongxun; LI Feng; GUO Jiayi; YAO Junna; MI Yufei; GUO Yanxing
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關鍵詞:
骨關節(jié)炎; 膝;  關節(jié)成形術; 置換; 膝;  截骨術;  脛骨
Keywords:
Key words osteoarthritis; knee;  arthroplasty; replacement; knee;  osteotomy;  tibia
摘要:
目的:探討單髁置換術治療中重度膝關節(jié)單間室骨關節(jié)炎的臨床療效。方法:2013年10月至2015年5月,共納入中重度膝關節(jié)單間室骨關節(jié)炎患者60例,Kellgren-Lawrence分級Ⅲ級25例、Ⅳ級35例; 隨機分為2組,每組30例,分別采用單髁置換術和脛骨高位截骨術治療。記錄2組患者手術時間、術中出血量、術后下床時間及住院時間。分別于術前和術后12個月,采用疼痛視覺模擬量表(visual analogue scale,VAS)評分和Lysholm膝關節(jié)評分評價患者膝關節(jié)疼痛和功能情況。結果:2組患者均順利完成手術。與脛骨高位截骨組相比,單髁置換組手術時間和住院時間較短、術中出血量少、術后下床早[(102.15±12.73)min,(125.79±16.26)min,t=29.762,P=0.046;(9.08±2.03)d,(24.02±3.82)d,t=37.285,P=0.031;(263.19±31.25)mL,(307.58±41.62)mL,t=49.193,P=0.026;(9.02±1.26)d,(67.56±9.64)d,t=76.183,P=0.021]。術前2組患者膝關節(jié)疼痛VAS評分及膝關節(jié)Lysholm評分組間比較,差異均無統(tǒng)計學意義[(8.54±0.86)分,(8.57±0.89)分,t=0.640,P=1.059;(58.42±5.39)分,(58.46±5.30)分,t=0.609,P=1.068]; 術后12個月,2組患者膝關節(jié)疼痛VAS評分均較術前降低[(1.56±0.35)分,(8.54±0.86)分,t=1.021,P=0.000;(3.07±0.61)分,(8.57±0.89)分,t=1.236,P=0.000],膝關節(jié)Lysholm評分均較術前增加[(90.28±5.05)分,(58.42±5.39)分,t=5.174,P=0.000;(83.97±6.19)分,(58.46±5.30)分,t=4.927,P=0.000],但2組患者膝關節(jié)疼痛VAS評分和膝關節(jié)Lysholm評分的組間差異均無統(tǒng)計學意義[(1.56±0.35)分,(3.07±0.61)分,t=2.045,P=0.189;(90.28±5.05)分,(83.97±6.19)分,t=7.617,P=0.165]。結論:與脛骨高位截骨術相比,單髁置換術治療中重度膝關節(jié)單間室骨關節(jié)炎,手術時間和住院時間短、術中出血少、下床活動時間早。2種方法均有利于膝關節(jié)疼痛的緩解和膝關節(jié)功能的恢復,且療效相當。
Abstract:
ABSTRACT Objective:To explore the clinical curative effects of unicondylar knee arthroplasty(UKA)in the treatment of moderate-to-severe unicompartmental knee osteoarthritis(KOA).Methods:Sixty patients with moderate-to-severe unicompartmental KOA were included from October 2013 to May 2015 and were randomly divided into 2 groups,30 cases in each group.The patients were treated with UKA and osteotomy of proximal tibia(OPT)respectively.According to Kellgren-Lawrence classification,the KOA belonged to gradeⅢ(25)andⅣ(35).The operative time,intraoperative blood loss,bed rest time and hospital stay were recorded and compared between the 2 groups.The knee pain and function were evaluated by using visual analogue scale(VAS)score and Lysholm knee score respectively before the surgery and at 12 months after the surgery.Results:The surgery were finished successfully in all patients.The operative time and hospital stay were shorter and the intraoperative blood loss was less and the bed rest time was shorter in UKA group compared to OPT group(102.15+/-12.73 vs 125.79+/-16.26 min,t=29.762,P=0.046; 9.08+/-2.03 vs 24.02+/-3.82 days,t=37.285,P=0.031; 263.19+/-31.25 vs 307.58+/-41.62 ml,t=49.193,P=0.026; 9.02+/-1.26 vs 67.56+/-9.64 days,t=76.183,P=0.021).There was no statistical difference in knee pain VAS scores and Lysholm knee scores between the 2 groups before treatment(8.54+/-0.86 vs 8.57+/-0.89 points,t=0.640,P=1.059; 58.42+/-5.39 vs 58.46+/-5.30 points,t=0.609,P=1.068).The knee pain VAS scores decreased in both of the 2 groups at 12 months after the surgery(1.56+/-0.35 vs 8.54+/-0.86 points,t=1.021,P=0.000; 3.07+/-0.61 vs 8.57+/-0.89 points,t=1.236,P=0.000).The Lysholm knee scores increased in both of the 2 groups at 12 month after the surgery(90.28+/-5.05 vs 58.42+/-5.39 points,t=5.174,P=0.000; 83.97+/-6.19 vs 58.46+/-5.30 points,t=4.927,P=0.000).However,there was no statistical difference in knee pain VAS scores and Lysholm knee scores between the 2 groups at 12 month after the surgery(1.56+/-0.35 vs 3.07+/-0.61 points,t=2.045,P=0.189; 90.28+/-5.05 vs 83.97+/-6.19 points,t=7.617,P=0.165).Conclusion:UKA has the advantages of shorter operative time and hospital stay,less intraoperative blood loss and shorter bed rest time compared to OPT in the treatment of moderate-to-severe unicompartmental KOA.Both of the 2 methods are conducive to knee pain relief and knee function recovery,and they are similar to each other in the total curative effect.

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備注/Memo

備注/Memo:
基金項目:河南省中醫(yī)臨床學科領軍人才培育計劃項目(HNZYLJ201301009); 國家中醫(yī)藥管理局“平樂郭氏正骨流派傳承工作室”建設項目(2012-228) 通訊作者:崔宏勛 E-mail:[email protected]
更新日期/Last Update: 2017-06-20