Fisher David A, Dalury David F, Adams Mary Jo, Shipps Melanie R, Davis Kenneth
OrthoIndy, Indianapolis, IN 46278, USA.
Orthopedics. 2010 Sep 7;33(9):668. doi: 10.3928/01477447-20100722-05.
This retrospective study compares the short-term outcomes of small-incision unicompartmental knee arthroplasty (41 patients) with standard total knee arthroplasty (TKA) (50 patients) in 91 consecutive patients older than 70 years. Knee Society Scores and range of motion (ROM) were assessed preoperatively, at 6 weeks and 6 months, and through a minimum of 2 years. Postoperative comparisons included blood loss, transfusions, narcotic consumption, length of hospital stay, and complications. While Knee Scores and ROM were similar preoperatively, both were better in the unicompartmental group at each postoperative time interval. Patients with unicompartmental replacements had a much quicker return of function and discontinuation of pain medication. Blood loss was significantly more for the TKA group, as was the need for blood transfusion. None of the unicompartmental patients required transfusion. Narcotic use and length of hospital stay were also significantly less for the unicompartmental group. The overall rate of postoperative medical and surgical complications was similar for the 2 groups, with 1 major complication in each. Overall, the physiologic impact of unicompartmental knee arthroplasty was much less than TKA in this older patient population and resulted in a faster recovery.
这项回顾性研究比较了91例70岁以上连续患者中，小切口单髁膝关节置换术（41例患者）与标准全膝关节置换术（TKA，50例患者）的短期疗效。在术前、术后6周和6个月以及至少2年的时间里，评估膝关节协会评分和活动范围（ROM）。术后比较包括失血量、输血情况、麻醉药物用量、住院时间和并发症。虽然术前膝关节评分和ROM相似，但在每个术后时间间隔，单髁组的这两项指标都更好。接受单髁置换的患者功能恢复更快，止痛药物停用更早。TKA组的失血量明显更多，输血需求也更大。单髁组患者均无需输血。单髁组的麻醉药物用量和住院时间也明显更短。两组术后医疗和手术并发症的总体发生率相似，每组各有1例主要并发症。总体而言，在这个老年患者群体中，单髁膝关节置换术对生理的影响远小于TKA，且恢复更快。
