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投稿时间：2023-08-27 网络发布日期：2024-05-20
投稿时间：2023-08-27 网络发布日期：2024-05-20
中文摘要: 目的 比较膝关节单髁置换术（UKA）与全膝关节置换术（TKA）对膝关节骨性关节炎（KOA）的治疗效果，为临床选择最佳手术方案提供参考。 方法 选取2020年2月至2021年2月石家庄市人民医院进行膝关节置换术治疗的104例KOA患者，根据KOA疾病分级及病变部位将患者分为单间室病变组36例（采取髌股关节置换术或UKA），双间室病变单组（行组配式双间室膝关节置换术）35例，三间室病变组（采用TKA）33例。随访术后18个月患者关节功能恢复情况，比较术前、术后各组患者膝关节的活动度（ROM）、美国膝关节学会评分系统（KSS）临床评分、KSS功能评分、日本骨科协会（JOA）评分以及血清白细胞介素（IL）-6、IL-7水平。 结果 术后，3组患者ROM评分、KSS临床评分、KSS功能评分及膝关节功能JOA评分较术前升高，且单间室病变组和双间室病变单组高于三间室病变组（P＜0.05）。术后，单间室病变组、双间室病变单组和三间室病变组优良率分别为72.22%、74.29%和66.67%，3组临床疗效差异无统计学意义（χ2=0.510,P=0.774）。术后，3组患者血清IL-6、IL-7水平较术前显著降低，且单间室病变组和双间室病变单组低于三间室病变组（P＜0.05）。 结论 UKA与TKA在KOA治疗中可获得较好疗效，根据膝关节疾病分级及病变位置选择合适手术方式可更好的促进KOA患者膝关节功能恢复，获得更佳治疗效果。
Abstract:Objective To compare the therapeutic effects of unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) on knee osteoarthritis (KOA) to provide references for the clinical selection of the best surgical approach. Methods A total of 104 KOA patients who underwent knee arthroplasty at Shijiazhuang People's Hospital from February 2020 to February 2021 were selected. Patients were divided into three groups based on the classification and lesion location of KOA: unicompartment lesion group (36 cases, undergoing patellofemoral joint replacement or UKA), two compartments lesion group (35 cases, undergoing simultaneous two compartments knee arthroplasty), and three compartments lesion group (33 cases，undergoing TKA). The postoperative recovery of joint function was followed up for 18 months. The range of motion (ROM), American Knee Society Score clinical score, KSS functional score, Japanese Orthopedic Association Assessment (JOA) score of knee joint, and serum interleukin (IL)-6 and IL-7 levels of patients were compared among three groups before and after surgery. Results After surgery, the ROM score, KSS clinical score, and KSS functional score, and JOA score of knee joint function in the three groups increased compared to preoperative values, with those in unicompartment lesion group and two compartments lesion group being higher than in three compartments lesion group (P＜0.05). After surgery, the excellent and good rate in the unicompartment lesion group, the two compartments lesion group and the three compartments lesion group were 72.22%, 74.29% and 66.67%, respectiuely. There was no statistically significant difference in clinical efficacy among the three groups (χ2=0.510, P=0.774). After surgery, the serum levels of IL-6 and IL-7 in the three groups significantly decreased compared to preoperative levels, with those in unicompartment lesion group and two compartments lesion group being lower than three compartments lesion group (P＜0.05). Conclusion Both UKA and TKA can achieve good therapeutic effects in the treatment of KOA. Choosing the appropriate surgical approach based on the classification and lesion location of knee joint diseases can better promote the recovery of knee joint function and achieve better treatment results in KOA patients.
keywords: Unicompartmental knee arthroplasty Total knee arthroplasty Knee osteoarthritis Knee joint function Patellofemoral joint replacement
文章编号： 中图分类号：R684 文献标志码：A
基金项目:河北省医学科学研究课题（20211615）
| Author Name | Affiliation |
| LI Xiaolin, LIU Xiaofeng, WANG Zhaojun, WANG Guixian | Department of Orthopedics, Shijiazhuang People's Hospital, Shijiazhuang, Hebei 050000, China |
引用文本：
李小林， 柳晓峰， 王朝君， 王贵贤.单踝与全膝关节置换术治疗膝关节骨性关节炎的效果[J].中国临床研究,2024,37(5):767-772.
李小林， 柳晓峰， 王朝君， 王贵贤.单踝与全膝关节置换术治疗膝关节骨性关节炎的效果[J].中国临床研究,2024,37(5):767-772.