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双间室膝关节置换术的早期不良结果:与全膝关节置换术的前瞻性队列比较。

Early adverse results with bicompartmental knee arthroplasty: a prospective cohort comparison to total knee arthroplasty.

机构信息

Center for Hip and Knee Replacement, Department of Orthopaedic Surgery, NewYork-Presbyterian at Columbia University, New York, New York 10032, USA.

出版信息

J Arthroplasty. 2011 Sep;26(6 Suppl):35-9. doi: 10.1016/j.arth.2011.03.041. Epub 2011 Jun 24.

Abstract

This prospective cohort study compares functional outcomes of bicompartmental knee arthroplasty (BKA) and total knee arthroplasty (TKA) in patients with osteoarthritis (OA) of the patellofemoral and medial compartments. Eligibility criteria included bicompartmental OA with less than grade 2 OA in the lateral compartment and intact cruciate ligaments. Fifty-six patients met eligibility criteria (21 BKA, 33 TKA). Enrolled participants completed Short-Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index assessments at baseline and postoperatively at 3 months, 1 year, and 2 years. In the early postoperative period, the BKA cohort had significantly less pain (P = .020) and better physical function (P = .015). These trends did not continue past 3 months. When adjusting for age, sex, body mass index, and preoperative status, only 3-month Western Ontario and McMaster Universities Osteoarthritis Index stiffness scores significantly differed between cohorts (P = .048). Despite less early stiffness in the BKA cohort, a significantly higher BKA complication rate (P = .045) has led us to recommend TKA for patients with this pattern of OA.

摘要

本前瞻性队列研究比较了髌股和内侧间室骨关节炎(OA)患者行双间室膝关节置换术(BKA)和全膝关节置换术(TKA)的功能结果。入选标准包括外侧间室OA 程度低于 2 级且交叉韧带完整的双间室 OA。56 名患者符合入选标准(21 例 BKA,33 例 TKA)。入组患者在基线和术后 3 个月、1 年和 2 年时分别完成简短健康调查量表 12 项(SF-12)和西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)评估。在术后早期,BKA 组疼痛明显减轻(P =.020),躯体功能更好(P =.015)。但这些趋势在 3 个月后并未持续。在校正年龄、性别、体重指数和术前状态后,只有 3 个月时的 WOMAC 僵硬评分在两组间有显著差异(P =.048)。尽管 BKA 组的早期僵硬程度较低,但 BKA 并发症发生率显著更高(P =.045),这促使我们建议对这种 OA 模式的患者行 TKA。

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