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[1]熊昌軍,左云周,嚴(yán)小康,等.膝關(guān)節(jié)單髁置換術(shù)治療高齡膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2025,37(01):45-50.
　XIONG Changjun,ZUO Yunzhou,YAN Xiaokang,et al.A clinical study of unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis in advanced age patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(01):45-50.
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膝關(guān)節(jié)單髁置換術(shù)治療高齡膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期數(shù):
2025年01期
頁碼:
45-50
欄目:
臨床研究
出版日期:
2025-01-20

文章信息/Info

Title:
A clinical study of unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis in advanced age patients
作者:
熊昌軍; 左云周; 嚴(yán)小康; 王冠; 付豪; 姜學(xué)明
武漢中西醫(yī)結(jié)合骨科醫(yī)院/武漢體育學(xué)院附屬醫(yī)院,湖北 武漢 430079
Author(s):
XIONG Changjun; ZUO Yunzhou; YAN Xiaokang; WANG Guan; FU Hao; JIANG Xueming
Wuhan Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine(The Affiliated Hospital of Wuhan Sports University),Wuhan 430079,Hubei,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  關(guān)節(jié)成形術(shù); 置換; 膝;  高齡
Keywords:
osteoarthritis; knee;  arthroplasty; replacement; knee;  advanced age
摘要:
目的:探討膝關(guān)節(jié)單髁置換術(shù)(unicompartmental knee arthroplasty,UKA)治療高齡膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎的臨床療效和安全性。方法:回顧性分析2020年1月至2023年7月接受UKA治療的80例膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎患者的病例資料,其中高齡組40例(年齡>75歲)、對照組40例(年齡55～75歲)。比較2組患者的住院時間、手術(shù)時間、術(shù)中出血量、術(shù)后引流量、并發(fā)癥發(fā)生情況,以及術(shù)前和末次隨訪時膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、美國特種外科醫(yī)院(Hospital for Special Surgery,HSS)膝關(guān)節(jié)評分、膝關(guān)節(jié)活動度、脛股角(femoral tibial angle,FTA)。結(jié)果:2組患者的住院時間、手術(shù)時間、術(shù)中出血量、術(shù)后引流量的組間差異均無統(tǒng)計學(xué)意義。80例患者均獲隨訪,高齡組隨訪時間(19.75±5.10)個月,對照組隨訪時間(21.65±5.83)個月。末次隨訪時,2組患者的膝關(guān)節(jié)疼痛VAS評分均低于術(shù)前[(5.60±0.87)分,(1.33±0.66)分,t=-24.730,P=0.000;(5.63±0.98)分,(1.28±0.60)分,t=-23.942,P=0.000],HSS膝關(guān)節(jié)評分均高于術(shù)前[(51.50±5.75)分,(86.33±3.15)分,t=33.560,P=0.000;(51.98±5.44)分,(89.53±3.63)分,t=36.315,P=0.000],膝關(guān)節(jié)活動度均大于術(shù)前(100.70°±8.33°,117.13°±8.31°,t=8.831,P=0.000; 99.88°±9.45°,116.75°±8.20°,t=8.528,P=0.000),FTA均小于術(shù)前(185.05°±3.62°,180.23°±2.45°,t=-6.974,P=0.000; 184.95°±3.90°,180.03°±2.31°,t=-6.865,P=0.000); 2組患者的膝關(guān)節(jié)疼痛VAS評分、膝關(guān)節(jié)活動度、FTA的組間差異均無統(tǒng)計學(xué)意義(t=-0.341,P=0.734; t=-0.198,P=0.844; t=-0.361,P=0.719); 高齡組患者的HSS膝關(guān)節(jié)評分小于對照組(t=4.041,P=0.000)。 2組患者術(shù)后并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學(xué)意義(χ2=1.726,P=0.189)。結(jié)論:對于年齡>75歲的高齡膝關(guān)節(jié)內(nèi)側(cè)間室骨關(guān)節(jié)炎患者,采用UKA治療可以緩解膝關(guān)節(jié)疼痛、改善膝關(guān)節(jié)活動度、糾正下肢力線和恢復(fù)膝關(guān)節(jié)功能,且安全性高; 其膝關(guān)節(jié)功能恢復(fù)不如年齡55～75歲的患者理想,但足以滿足日常生活需求。
Abstract:
Objective:To explore the clinical outcomes and safety of unicompartmental knee arthroplasty(UKA)for treatment of medial compartment knee osteoarthritis(KOA)in advanced age patients.Methods:The medical records of 80 patients who underwent UKA for medial compartment KOA from January 2020 to July 2023 were retrospectively analyzed.The patients were divided into 2 groups according to the age,the ones aged over 75 years old were assigned into advanced-aged group(40 cases),and the ones ranged in age from 55 to 75 years old into control group(40 cases).The hospital stays,operative time,intraoperative blood loss,postoperative drainage volume,and complications were compared between the 2 groups.Furthermore,the knee pain visual analog scale(VAS)score,Hospital for Special Surgery(HSS)knee score,knee range of motion(ROM),and femoral tibial angle(FTA)measured before the surgery and at the last follow-up were also compared between the 2 groups,respectively.Results:There was no statistical difference in hospital stays,operative time,intraoperative blood loss,and postoperative drainage volume between the 2 groups.All patients in the 2 groups were followed up.The patients in the advanced-aged group were followed up for 19.75±5.10 months,and the ones in control group for 21.65±5.83 months.The knee pain VAS score and FTA decreased,while the HSS knee score and knee ROM increased at the last follow-up compared to pre-surgery in the 2 groups (5.60±0.87 vs 1.33±0.66 points,t=-24.730,P=0.000; 5.63±0.98 vs 1.28±0.60 points,t=-23.942,P=0.000; 185.05±3.62 vs 180.23±2.45 degrees,t=-6.974,P=0.000; 184.95±3.90 vs 180.03±2.31 degrees,t=-6.865,P=0.000; 51.50±5.75 vs 86.33±3.15 points,t=33.560,P=0.000; 51.98±5.44 vs 89.53±3.63 points,t=36.315,P=0.000; 100.70±8.33 vs 117.13±8.31 degrees,t=8.831,P=0.000; 99.88±9.45 vs 116.75±8.20 degrees,t=8.528,P=0.000).Further comparison at the last follow-up revealed that there was no statistical difference in the knee pain VAS score,knee ROM and FTA between the 2 groups(t=-0.341,P=0.734; t=-0.198,P=0.844; t=-0.361,P=0.719); while,the HSS knee score was lower in advanced-aged group compared to control group(t=4.041,P=0.000).In addition,there was no statistical difference in the postsurgical complication incidence between the 2 groups(χ2=1.726,P=0.189).Conclusion:UKA can alleviate the knee pain,improve the knee ROM,correct the lower limb alignment,and restore the knee function in treatment of medial compartment KOA in patients aged over 75 years old,and it exhibits high safety.Although the recovery of knee function in patients aged over 75 years old is not as ideal as that in patients aged 55-75 years old,it is enough for the daily life.

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通訊作者:左云周 E-mail:[email protected]
更新日期/Last Update: 1900-01-01