标题：全膝关节置换术与单髁置换术治疗膝单间室骨性关节炎疗效比较

      作者：郑越生，何炜，赖业孟    广州中医药大学金沙洲医院骨科中心，广东 广州 510168

      卷次： 2019年30卷9期

      【摘要】 目的 比较全膝关节置换术(TKA)与单髁置换术(UKA)治疗膝单间室骨性关节炎(KOA)的临床疗效。方法 选择 2015年 1月至 2017年 10月期间广州中医药大学金沙洲医院骨科中心收治的 62例KOA (内侧间室)患者为研究对象，根据手术方式的不同，将接受UKA治疗的患者32例纳入UKA组，接受TKA治疗的30例患者纳入TKA组。比较两组患者围手术期的临床指标，以及随访 6个月、12个月时膝关节活动度(ROM)、纽约特种外科医院膝关节(HSS)评分。结果 UKA组患者的手术时间、膝关节主动屈曲至 90°时间、住院时间分别为(72.3±5.4) min、(6.8±2.2) d、(8.8±2.4) d，均明显短于TKA组的(84.2±10.9) min、(10.1±3.2) d、(10.6±3.7) d，术中出血量为(167.2±39.4) mL，明显少于TKA组的(304.1±78.3) mL，差异均有统计学意义(P<0.05)；术后6个月，UKA组患者的ROM为(109.8±10.6)°，明显大于TKA组的(94.1±7.6)°，差异有统计学意义(P<0.05)；术后12个月，UKA组和TKA组患者的ROM分别为(113.5±11.5)°、(110.6±9.8)°，两组间比较差异无统计学意义(P>0.05)；术后6个月、12个月UKA组和TKA组患者的HSS评分分别为(85.3±7.2)分、(87.4±8.1)分和(84.6±6.8)分、(88.6±6.3)分，组间比较差异均无统计学意义(P>0.05)。结论 全膝关节置换术与单髁置换术均是治疗膝单间室骨性关节炎的有效术式，对改善患者膝关节功能效果确切，但UKA具有创伤小、出血量少及术后恢复快的优势。
      【关键词】 全膝关节置换术；单髁置换术；膝骨性关节炎；单间室；疗效
      【中图分类号】 R687.4 【文献标识码】 A 【文章编号】 1003—6350（2019）09—1117—03

A comparative study of total knee arthroplasty and unicondylar arthroplasty in the treatment of unicompartmentosteoarthritis of the knee.
ZHENG Yue-sheng, HE Wei, LAI Ye-meng. Orthopaedic Center, Jinshazhou Hospital,Guangzhou University of Traditional Chinese Medicine, Guangzhou 510168, Guangdong, CHINA
【Abstract】 Objective To compare the efficacy of total knee arthroplasty (TKA) and unicondylar arthroplasty(UKA) in the treatment of unicompartment osteoarthritis of the knee. Methods From January 2015 to October 2017,62 patients with unicompartment osteoarthritis of the knee treated in Orthopaedic Center, Jinshazhou Hospital, Guang-zhou University of Traditional Chinese Medicine were selected as the study subjects, of which 32 patients receivingUKA treatment were included into UKA group and 30 patients receiving TKA treatment were included into TKA group.The perioperative clinical indicators were compared, range of motion (ROM), and hospital for special surgery knee(HSS) scores at 6 and 12 months of follow-up were compared between the two groups. Results The operation time, ac-tive knee flexion to 90°, hospitalization time in UKA group were (72.3±5.4) min, (6.8±2.2) d, (8.8±2.4) d, significantlyshorter than (84.2±10.9) min, (10.1±3.2) d, (10.6±3.7) d in TKA group, and the amount of bleeding during operationwas (167.2 ± 39.4) mL, significantly less than (304.1 ± 78.3) mL in TKA group (P<0.05). ROM in UKA group was(109.8±10.6)° at 6 months after operation, significantly higher than (94.1±7.6)° in TKA group (P<0.05). At 12 monthsafter operation, ROM was (113.5±11.5)° in UKA group and (110.6±9.8)° in TKA group, with no significant differencebetween the two groups (P>0.05). HSS scores at 6 months and 12 months after operation were 85.3±7.2, 87.4±8.1 inUKA group and 84.6±6.8, 88.6±6.3 in TKA group, with no significant difference between the two groups (P>0.05).Conclusion Both TKA and UKA are effective methods for the treatment of unicompartment osteoarthritis of the knee,which have definite effect on improving knee function of patients, but UKA has advantages of less trauma, less bleeding,and quick recovery after operation.
      【Key words】 Total knee arthroplasty; Unicondylar replacement; Knee osteoarthritis; Unicompartment; Therapeu-tic effect