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单髁置换与全膝关节置换治疗内侧骨关节炎:基于注册数据分析和功能结局的回顾性研究。

Unicondylar vs. total knee arthroplasty in medial osteoarthritis: a retrospective analysis of registry data and functional outcome.

机构信息

Department of Orthopaedics, Medical University of Innsbruck, Innsbruck, Austria.

Innsbruck Institute of Patient-Centered Outcome Research (IIPCOR), Innsbruck, Austria.

出版信息

Arch Orthop Trauma Surg. 2020 Apr;140(4):545-549. doi: 10.1007/s00402-020-03377-8. Epub 2020 Feb 25.

Abstract

PURPOSE

It was the aim of our study to compare the functional outcome (WOMAC score, range of motion) achieved with unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA). It was hypothesized that UKA and TKA would differ with regard to the WOMAC function scale (hypothesis 1) and the WOMAC total scale (hypothesis 2). It was assumed that the groups would differ with respect to changes in range of motion (ROM) over time (hypothesis 3).

METHODS

A retrospective comparative study was conducted to analyze data available from the federal state's Arthroplasty Registry (WOMAC score) and from clinical routine (ROM). Patients who underwent UKA or TKA between 2008 and 2015 were considered. ANOVAs for repeated measurements were applied, adjusted for age, to test hypotheses 1-3.

RESULTS

The UKA group was comprised of 112 patients (age 65, BMI 29). The TKA group included 330 cases (age 69, BMI 29). Regarding hypothesis 1, the amount of improvement in WOMAC function was not influenced by the surgical group (no significant grouptime interactions, p = 0.608). Similarly, for hypothesis 2, the amount of improvement in the WOMAC total score was not influenced by the surgical group (no significant grouptime interactions, p = 0.392). Regarding hypothesis 3, we found no significant group*time interaction for the ROM data (p = 0.731).

CONCLUSIONS

On the basis of our findings, it is concluded that whether knee osteoarthritis is treated with either medial UKA or TKA has no influence on the WOMAC total score or any of the WOMAC subscales. It has no effect on early or late ROM gain.

摘要

目的

本研究旨在比较单髁膝关节置换术(UKA)和全膝关节置换术(TKA)的功能结果(WOMAC 评分、关节活动度)。假设 UKA 和 TKA 在 WOMAC 功能量表(假设 1)和 WOMAC 总分量表(假设 2)方面存在差异。假设两组在随时间变化的关节活动度(ROM)变化方面存在差异(假设 3)。

方法

进行了一项回顾性比较研究,以分析来自联邦州关节置换登记处(WOMAC 评分)和临床常规(ROM)的数据。考虑了 2008 年至 2015 年间接受 UKA 或 TKA 的患者。应用重复测量方差分析,调整年龄因素,检验假设 1-3。

结果

UKA 组包括 112 例患者(年龄 65 岁,BMI 29)。TKA 组包括 330 例患者(年龄 69 岁,BMI 29)。关于假设 1,WOMAC 功能评分的改善量不受手术组的影响(无显著的组间时间交互作用,p=0.608)。同样,对于假设 2,WOMAC 总分的改善量不受手术组的影响(无显著的组间时间交互作用,p=0.392)。关于假设 3,我们发现 ROM 数据的组间时间交互作用无统计学意义(p=0.731)。

结论

根据我们的发现,可以得出结论,膝关节骨关节炎采用内侧 UKA 或 TKA 治疗对 WOMAC 总分或任何 WOMAC 子量表均无影响。对早期或晚期 ROM 增加没有影响。

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