The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Møllendalsbakken 11, N-5021 Bergen, Norway.
J Bone Joint Surg Am. 2010 Dec 15;92(18):2890-7. doi: 10.2106/JBJS.I.00917.
Unicompartmental knee arthroplasty has received renewed interest; however, its short-term advantages over total knee arthroplasty should be weighed against a higher risk of reoperation. Information regarding pain and function after unicompartmental and total knee arthroplasty is therefore needed.
Patient-reported data regarding pain and function were collected, at least two years postoperatively and by way of postal questionnaire, from 1344 patients who were listed on the Norwegian Arthroplasty Register as having had an unrevised primary total knee arthroplasty (972 patients) or a unicompartmental knee arthroplasty (372 patients) for the treatment of arthritis. Outcomes were assessed (with a score of zero indicating the worst possible outcome and a score of 100 indicating the best possible outcome) with use of the five subscales from the Knee Injury and Osteoarthritis Outcome Score, the scores from visual analog scales regarding degree of pain and satisfaction with the surgery, and the change in index score (from preoperative to postoperative) on the EuroQol-5D health-related quality-of-life instrument. We also used all forty-two questions from the Knee Injury and Osteoarthritis Outcome Score as outcome measures. To be regarded as clinically significant, the differences needed to be eight units for the Knee Injury and Osteoarthritis Outcome Score outcomes, ten units for the pain and satisfaction scales, and 0.4 unit for the detailed Knee Injury and Osteoarthritis Outcome Score questions.
Unicompartmental knee implants performed better than total knee implants on the Knee Injury and Osteoarthritis Outcome subscales for "Symptoms" (adjusted mean difference, 2.7; p = 0.04), "Function in Daily Living" (adjusted mean difference, 4.1; p = 0.01), and "Function in Sport and Recreation" (adjusted mean difference, 5.4; p = 0.006). Of the forty-two analyses of the detailed questions, four differences were significant. These differences were in favor of unicompartmental knee arthroplasty, but only the question "Can you bend your knee fully?" reached the level of clinical significance.
We found only small or no differences in pain and function between the scores, at least two years following surgery, of patients who underwent unicompartmental knee arthroplasty and those of patients who underwent total knee arthroplasty; however, patients with unicompartmental knee implants had fewer problems with activities that involved bending the knee.
单髁膝关节置换术重新受到关注；然而，其与全膝关节置换术相比的短期优势应权衡其更高的再手术风险。因此，需要了解单髁和全膝关节置换术后的疼痛和功能信息。
通过邮寄问卷，至少在术后两年收集了挪威关节置换登记处列出的 1344 名未行翻修的原发性全膝关节置换术（972 例）或单髁膝关节置换术（372 例）患者的疼痛和功能的患者报告数据。采用膝关节损伤和骨关节炎评分（Knee Injury and Osteoarthritis Outcome Score，KOOS）的五个亚量表、视觉模拟量表（visual analog scale，VAS）的疼痛程度和手术满意度评分、以及 EuroQol-5D 健康相关生活质量量表（EQ-5D）的指数评分（从术前到术后）来评估结果（得分 0 表示最差，100 表示最好）。我们还使用了 KOOS 的全部 42 个问题作为结果测量指标。需要 8 个单位的 KOOS 结果、10 个单位的疼痛和满意度量表以及 0.4 个单位的详细 KOOS 问题，才能被认为具有临床意义。
在 KOOS 亚量表“症状”（调整平均差异，2.7；p = 0.04）、“日常生活活动功能”（adjusted mean difference，4.1；p = 0.01）和“运动和娱乐活动功能”（adjusted mean difference，5.4；p = 0.006）中，单髁膝关节植入物的表现优于全膝关节植入物。在 42 项详细问题分析中，有 4 项差异有统计学意义。这些差异有利于单髁膝关节置换术，但只有“您能否完全弯曲膝盖？”这一问题达到了临床意义的水平。
我们发现，至少在术后两年，行单髁膝关节置换术的患者与行全膝关节置换术的患者的疼痛和功能评分之间仅有较小或无差异；然而，单髁膝关节植入物患者的膝关节弯曲活动问题较少。
