Zheng Chong, Lu Weijie, Li Zhichen, Zhou Junjie, Chen Dongfeng, Wu Yingbin
Department of Orthopedic Arthrosurgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510000, P.R.China.
Department of Orthopedics, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Apr 15;34(4):442-446. doi: 10.7507/1002-1892.201909143.
To investigate the effect of body mass index (BMI) on the short- and medium-term effectiveness of unicompartmental knee arthroplasty (UKA) in the treatment of anterior medial compartmental osteoarthritis of knee joint.
The clinical data of 55 patients (61 knees) with anterior medial compartmental osteoarthritis of knee joint treated with minimally invasive UKA between May 2014 and May 2019 were retrospectively analyzed. According to BMI, the patients were divided into 3 groups: normal body mass group [group A, BMI 18.50-24.99 kg/m , 23 cases (25 knees)], overweight group [group B, BMI 25.00-29.99 kg/m , 23 cases (25 knees)], obesity group [group C, BMI 30.00-39.99 kg/m , 9 cases (11 knees)]. There was no significant difference in gender, age, sides, disease duration, and preoperative American Special Surgery Hospital (HSS) score, pain visual analogue scale (VAS) score, and knee range of motion (ROM) among 3 groups ( >0.05). The operation time, intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week were recorded and compared among 3 groups. The HSS score, VAS score, and ROM were used to evaluate the knee function and pain improvement.
There was no significant difference in the operation time, the intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week among 3 groups ( >0.05). All the 55 patients were followed up 5-60 months, with an average of 24 months. No complication such as infection, fat embolism, or deep venous thrombosis of lower extremity occurred after operation. The anteroposterior and lateral X-ray films of the knee joint showed that no dislocation or loosening of the prosthesis occurred and the position of the prosthesis was good. At last follow-up, the HSS score, VAS score, and ROM of the 3 groups were significantly improved when compared with preoperative ones ( <0.05); but there was no significant difference among 3 groups ( >0.05).
For obese and overweight patients with anterior medial compartmental osteoarthritis of the knee joint, the use of minimally invasive UKA can achieve satisfactory short- and medium-term effectiveness, and the long-term effectiveness needs further follow-up.
探讨体重指数(BMI)对单髁膝关节置换术(UKA)治疗膝关节前内侧间室骨关节炎的短期和中期疗效的影响。
回顾性分析2014年5月至2019年5月间采用微创UKA治疗的55例(61膝)膝关节前内侧间室骨关节炎患者的临床资料。根据BMI将患者分为3组:正常体重组[A组,BMI 18.50 - 24.99 kg/m²,23例(25膝)],超重组[B组,BMI 25.00 - 29.99 kg/m²,23例(25膝)],肥胖组[C组,BMI 30.00 - 39.99 kg/m²,9例(11膝)]。3组在性别、年龄、患侧、病程以及术前美国特种外科医院(HSS)评分、疼痛视觉模拟量表(VAS)评分和膝关节活动度(ROM)方面差异均无统计学意义(P > 0.05)。记录并比较3组的手术时间、术中显性失血量以及术后1周血红蛋白下降量。采用HSS评分、VAS评分和ROM评估膝关节功能及疼痛改善情况。
3组在手术时间、术中显性失血量以及术后1周血红蛋白下降量方面差异均无统计学意义(P > 0.05)。55例患者均获随访,随访时间5 - 60个月,平均24个月。术后未发生感染、脂肪栓塞或下肢深静脉血栓等并发症。膝关节正侧位X线片显示假体无脱位或松动,假体位置良好。末次随访时,3组的HSS评分、VAS评分和ROM较术前均显著改善(P < 0.05);但3组间差异无统计学意义(P > 0.05)。
对于肥胖和超重的膝关节前内侧间室骨关节炎患者,采用微创UKA可获得满意的短期和中期疗效,长期疗效有待进一步随访观察。