[1]吴常杰,闫帮楷,李英祥,等.单髁置换术与全膝关节置换术治疗膝骨关节炎的早期疗效评价[J].医学信息,2024,37(08):109-113.[doi:10.3969/j.issn.1006-1959.2024.08.021]
 WU Chang-jie,YAN Bang-kai,LI Ying-xiang,et al.Early Efficacy Evaluation of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis[J].Journal of Medical Information,2024,37(08):109-113.[doi:10.3969/j.issn.1006-1959.2024.08.021]
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单髁置换术与全膝关节置换术治疗膝骨关节炎的早期疗效评价()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年08期
页码:
109-113
栏目:
论著
出版日期:
2024-04-15

文章信息/Info

Title:
Early Efficacy Evaluation of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis
文章编号:
1006-1959(2024)08-0109-05
作者:
吴常杰闫帮楷李英祥
(1.新疆生产建设兵团第六师奇台医院骨科,新疆 昌吉 831800;2.新疆医科大学附属肿瘤医院核医学科,新疆 乌鲁木齐 830011)
Author(s):
WU Chang-jieYAN Bang-kaiLI Ying-xianget al.
(1.Department of Orthopaedics,Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps,Changji 831800,Xinjiang,China;2.Department of Nuclear Medicine,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,Xinjiang,China)
关键词:
骨性关节炎单髁置换术全膝关节置换术膝关节活动度
Keywords:
Knee osteoarthritisUnicompartmental knee arthroplastyTotal knee arthroplastyRange of motion
分类号:
R687.4
DOI:
10.3969/j.issn.1006-1959.2024.08.021
文献标志码:
A
摘要:
目的 评价单髁置换术(UKA)与全膝关节置换术(TKA)治疗膝骨关节炎的早期疗效差异。方法 纳入2020年6月-2022年2月于新疆生产建设兵团第六师奇台医院就诊的符合手术治疗的膝骨关节炎患者77例,按照治疗方式不同分为UKA组(n=35)和TKA组(n=42)。UKA组予以UKA,TKA组予以TKA,比较两组临床指标(手术时间、术中出血、术后引流量、住院时间)、膝关节疼痛及活动度[疼痛视觉模拟评分(VAS)、膝关节活动度(ROM)]、预后(WOMAC评分)、经济负担。结果 UKA组手术时间、住院时间短于TKA组,术中出血、术后引流量少于TKA组,但差异无统计学意义(P>0.05);两组术后VAS评分低于术前,ROM高于术前,且UKA组VAS评分、ROM低于TKA组,差异有统计学意义(P<0.05);两组术后1周及1、3、6、12个月WOMAC评分低于术前,且UKA组术后3个月WOMAC评分低于TKA组,差异有统计学意义(P<0.05);UKA组术后总费用评分低于TKA组,其中材料费UKA组低于TKA组,差异有统计学意义(P<0.05)。结论 UKA术式在早期缓解膝骨关节炎患者疼痛、降低WOMAC评分、减轻经济负担方面具有更好的优势,而TKA术式能更好地恢复患者膝关节活动度,因此临床上应综合评价患者预后的差异及经济条件后再选择适宜的手术方式。
Abstract:
Objective To evaluate the early efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in the treatment of knee osteoarthritis.Methods From June 2020 to February 2022, 77 patients with knee osteoarthritis who met the surgical treatment in Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps were included. According to different treatment methods, they were divided into UKA group (n=35) and TKA group (n=42). UKA group was treated with UKA, and TKA group was treated with TKA. The clinical indexes (operation time, intraoperative bleeding, postoperative drainage volume, hospitalization time), knee joint pain and activity [Visual Analogue Scale (VAS), range of motion (ROM)], prognosis (WOMAC score) and economic burden were compared between the two groups.Results The operation time and hospitalization time of UKA group were shorter than those of TKA group, and the intraoperative bleeding and postoperative drainage volume were less than those of TKA group, but the differences were not statistically significant (P>0.05). The VAS score of the two groups after operation was lower than that before operation, and the ROM was higher than that before operation, while the VAS score and ROM of the UKA group were lower than those of the TKA group, and the differences were statistically significant (P<0.05). The WOMAC score of the two groups at 1 week, 1 month, 3 months, 6 months and 12 months after operation was lower than that before operation, and the WOMAC score of the UKA group at 3 months after operation was lower than that of the TKA group, the differences was statistically significant (P<0.05). The total cost score of the UKA group was lower than that of the TKA group, and the material cost of the UKA group was lower than that of the TKA group, the difference was statistically significant (P<0.05).Conclusion UKA has better advantages in relieving pain, reducing WOMAC score and reducing economic burden in patients with knee osteoarthritis in the early stage, while TKA can better restore the knee joint activity of patients. Therefore, the difference of prognosis and economic conditions of patients should be comprehensively evaluated before selecting the appropriate surgical method.

参考文献/References:

[1]Driban JB,Harkey MS,Barbe MF,et al.Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review[J].BMC Musculoskelet Disord,2020,21(1):332.[2]Hsu KY,Tsai YF,Yeh WL,et al.Triggers and decision-making patterns for receiving total knee arthroplasty among older adults with knee osteoarthritis:A qualitative descriptive study[J].J Clin Nurs,2018,27(23-24):4373-4380.[3]Briggs KK,Kocher MS,Rodkey WG,et al.Reliability,Validity,and Responsiveness of the Lysholm Knee Score and Tegner Activity Scale for Patients with Meniscal Injury of the Knee[J].J Bone Joint Surg Am,2006,88(4):698-705.[4]中国医院协会临床新技术应用专业委员会,中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组.中国膝关节周围截骨下肢力线矫正术治疗膝关节骨关节炎临床指南[J].中华骨科杂志,2021,41(23):1655-1672.[5]Copsey B,Thompson JY,Vadher K,et al.Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials[J].Qual Life Res,2018,28(2):335-343.[6]Driban JB,Price LL,Lu B,et al.The natural history of end-stage knee osteoarthritis:Data from the osteoarthritis initiative[J].Semin Arthritis Rheu,2022,58:152148.[7]Daszkiewicz K,?覵uczkiewicz P.Biomechanics of the medial meniscus in the osteoarthritic knee joint[J].Peer J,2021,9:e12509.[8]Xing R,Wang P,Zhao L,et al.Mechanism of TRPA1 and TRPV4 Participating in Mechanical Hyperalgesia of Rat Experimental Knee Osteoarthritis[J].Arch Rheumatol,2017,32(2):96-104.[9]Mittal S,Pradhan G,Singh S,et al.T1 and T2 mapping of articular cartilage and menisci in early osteoarthritis of the knee using 3-Tesla magnetic resonance imaging[J].Pol J Radiol,2019,84:e549-e564.[10]Sukerkar PA,Doyle Z.Imaging of Osteoarthritis of the Knee[J].Radiol Clin N Am,2022,60(4):605-616.[11]Sun X,Su Z.A meta-analysis of unicompartmental knee arthroplasty revised to total knee arthroplasty versus primary total knee arthroplasty[J].J Orthop Surg Res,2018,13(1):158.[12]Khachian A,Seyedoshohadaei M,Haghani H,et al.Effect of self-management program on outcome of adult knee osteoarthritis[J].Int J Orthop Trauma,2020,39:100797.[13]Güng?觟r Demir U,Demir AN,Toraman NF.Neuropathic pain in knee osteoarthritis[J].Adv Rheumatol,2021,61(1):67.[14]Blevins JL,Carroll KM,Burger JA,et al.Postoperative outcomes of total knee arthroplasty compared to unicompartmental knee arthroplasty:A matched comparison[J].Knee,2020,27(2):565-571.[15]Knifsund J,Niinimaki T,Nurmi H,et al.Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty:two-year results of a randomised,assessor-blinded multicentre trial[J].BMJ Open,2021,11(6):e046731.[16]Tille E,Beyer F,Auerbach K,et al.Better short-term function after unicompartmental compared to total knee arthroplasty[J].BMC Musculoskelet Disord,2021,22(1):326.[17]Tan MWP,Ng SWL,Chen JY,et al.Long-Term Functional Outcomes and Quality of Life at Minimum 10-Year Follow-Up After Fixed-Bearing Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty for Isolated Medial Compartment Osteoarthritis[J].J Arthroplasty,2020,36(4):1269-1276.[18]Kievit AJ,Kuijer PPFM,de Haan LJ,et al.Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty[J].Knee Surg Sport Tr A,2019,28(9):2905-2916.[19]Jeon YS,Ahn CH,Kim MK.Comparison of HTO with articular cartilage surgery and UKA in unicompartmental OA[J].J Orthop Surg (Hong Kong),2017,25(1):2309499016684092.[20]Tu Y,Ma T,Wen T,et al.Does Unicompartmental Knee Replacement Offer Improved Clinical Advantages Over Total Knee Replacement in the Treatment of Isolated Lateral Osteoarthritis? A Matched Cohort Analysis From an Independent Center[J].J Arthroplasty,2020,35(8):2016-2021.[21]Stukenborg-Colsman C,Wirth CJ,Lazovic D,et al.High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis:7-10-year follow-up prospective randomised study[J].Knee,2001,8(3):187-194.[22]Chisari E,Yu AS,Yayac M,et al.Despite Equivalent Medicare Reimbursement,Facility Costs for Outpatient Total Knee Arthroplasty Are Higher Than Unicompartmental Knee Arthroplasty[J].J Arthroplasty,2020,36(7S):S141-S144.[23]Yamagami R,Inui H,Jo T,et al.Unicompartmental knee arthroplasty is associated with lower proportions of surgical site infection compared with total knee arthroplasty:A retrospective nationwide database study[J].Knee,2020,28:124-130.[24]Lombardi AV,Kolich MT,Berend KR,et al.Revision of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty:Is It as Good as a Primary Result[J]. J Arthroplasty,2018,33(7S):S105-S108.[25]Smith WB 2nd,Steinberg J,Scholtes S,et al.Medial compartment knee osteoarthritis:age-stratified cost-effectiveness of total knee arthroplasty,unicompartmental knee arthroplasty,and high tibial osteotomy[J].Knee Surg Sports Traumatol Arthrosc,2017,25(3):924-933.

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更新日期/Last Update: 1900-01-01