【摘要】 目的比较单髁置换术及全膝置换术治疗膝关节单间室病变对患者股骨内髁参数和预后转归的影响。方法选取2015年1月至2017年1月因膝关节单间室病变在黄石市中心医院骨关节外科接受治疗的120例患者作为研究对象,按照患者意愿将患者分为单髁置换术组(n=60)和全膝置换术组(n=60),分别对患者行手术治疗,比较两组患者术后的股骨内髁参数、术后6个月和12个月时的膝关节功能(HSS评分表)、术后主动屈曲超过90°所用的时间及术后12个月主动屈曲超过120°的人数比例。术后12个月随访两组患者术后踝关节并发症情况。结果治疗后,两组患者冠状位及横断面后髁最远点的圆弧直径比较差异均无统计学意义(P>0.05),但单髁置换术组矢状位后髁最远点的圆弧直径为(42.58±1.44) cm,明显小于全膝置换术组的(45.47±1.33) cm,差异有统计学意义(P<0.05)。单髁置换术组患者术后主动屈曲超过90°用时为(6.74±1.87) d,明显少于全膝置换术组的(10.39±4.13) d,术后12个月主动屈曲超过120°人数占比为71.53%,明显高于全膝置换术组的44.64%,差异均有统计学意义(P<0.05);术后两次对患者膝关节功能进行比较,单髁置换术组患者的HSS评分均高于全膝置换术组[术后6个月:(74.00±5.75)分vs (69.01±6.33)分;术后12个月:(86.83±7.85)分vs (80.18±7.92)分],差异均有统计学意义(P<0.05);单髁置换术组患者术后12个月的并发症发生率为11.67%,明显低于全膝置换术组的28.33%,差异有统计学意义(P<0.05)。结论单髁置换术治疗膝关节单间室病变具有对股骨内髁参数影响小,患者术后膝关节功能恢复较快的特点,建议在临床治疗中推广使用。更多还原

【Abstract】 Objective To compare the effects of unicompartment arthroplasty and total knee arthroplasty on femoral internal condylar parameters and prognosis in the treatment of single compartment knee disease. Methods In this prospective study, 120 patients with single compartment lesions of knee joints who were treated in the Department of Osteoarthroplasty, Huangshi Central Hospital from January 2015 to January 2017 were selected as the research objects. The patients were divided into unicompartment arthroplasty group(n=60) and total knee arthroplasty group(n=60)according to the treatment needs of patients. The femoral internal condylar parameters, knee joint function(HSS scale) at6 months and 12 months after operation, the time of active flexion exceeding 90° after operation, and the proportion of patients with active flexion exceeding 120° at 12 months after operation were compared. Postoperative ankle complications were followed up for 12 months. Results After treatment, there was no significant difference in the diameters of the farthest point of the posterior condyle between the two groups on coronal position and on transverse section(P>0.05), but the diameter of the farthest point of the posterior condyle in the unicompartment arthroplasty group were smaller than that in the total knee arthroplasty group:(42.58±1.44) cm vs(45.47±1.33) cm(P<0.05). The time of active flexion exceeding 90° after operation in the unicompartment arthroplasty group was less than that in the total knee arthroplasty group:(6.74±1.87) d vs(10.39±4.13) d, P<0.05, and the proportion of patients with active flexion exceeding 120°at 12 months after operation in the unicompartment arthroplasty group was higher(71.53% vs 44.64%, P<0.05). The HSS scores in the unicompartment arthroplasty group were higher than those in the total knee arthroplasty group at 6 months after operation and at 12 months after operation, and the differences were statistically significant(P<0.05):(74.00±5.75) vs(69.01±6.33),(86.83±7.85) vs(80.18±7.92). The incidence of complications in unicompartment arthroplasty group was 11.67% at 12 months after operation, which was significantly lower than 28.33% in total knee arthroplasty group(P<0.05). Conclusion For the treatment of single compartment disease of knee joint, unicompartment arthroplasty has the characteristics of less influence on femoral internal condyle parameters and quicker recovery of knee joint function after operation. It is suggested that unicompartment arthroplasty should be popularized in clinical treatment.更多还原