Pei Z, Ding Z T, Li Z, Guan Z P
Department of Joint Surgery, Peking University People's Hospital, Beijing 100044, China (Pei Zheng is working at the Department of Orthopaedics, Peking University Shougang Hospital, Beijing 100144, China).
Department of Joint Surgery, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2020 Jun 1;58(6):452-456. doi: 10.3760/cma.j.cn112139-20200322-00244.
To compare the short-term efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty(TKA) in the treatment of medial compartmental knee osteoarthritis. A retrospective analysis was performed on 197 patients with medial compartment osteoarthritis of the knee treated by the same group of doctors from January 2015 to December 2018.There were 86 males and 111 females, aged (67.7±10.5) years (range: 46 to 92 years), among which 101 cases received UKA and 96 cases received TKA.The UKA and TKA patients were matched by the propensity score matching method, and a total of 41 pairs of patients were successfully matched.The difference of short-term outcomes between the two groups were compared by test, χ(2) test or Fisher exact probability methods. Compared with TKA group, the postoperative reduction of hemogloblin in the UKA group was lower ((15.3±6.4) g/L . (20.1±7.5) g/L, 3.117, 0.01), opioid dosage was lower ((160.5±29.3) mg . (186.1±46.8) mg, 2.969, 0.01), and the length of hospital stay was shorter ((7.0±2.0)d . (10.0±2.5)d, -6.000, 0.01). Forgotten joint score of UKA group was higher ( (65.1±7.6) . (58.3±13.9) , 2.732, 0.01), the incidence of knee clunk or crepitus was lower (0.03) . There was no significant difference in the time of surgical tourniquet, range of motion, American knee society clinical score and incidence of deep vein thrombosis in lower extremities between the two groups.No complications such as surgical site infection, prosthesis loosening and dislocation occurred in the two groups. The early effect of UKA is similar to that of TKA, and it is better than TKA in the aspects of knee clunk or crepitus, forgotten joint score, blood loss, opioid dosage and postoperative hospital stay.
比较单髁膝关节置换术(UKA)和全膝关节置换术(TKA)治疗膝关节内侧间室骨关节炎的短期疗效。对2015年1月至2018年12月由同一组医生治疗的197例膝关节内侧间室骨关节炎患者进行回顾性分析。其中男性86例,女性111例,年龄(67.7±10.5)岁(范围:46至92岁),其中101例行UKA,96例行TKA。采用倾向评分匹配法对UKA和TKA患者进行匹配,共成功匹配41对患者。采用t检验、χ²检验或Fisher确切概率法比较两组短期结局的差异。与TKA组相比,UKA组术后血红蛋白下降幅度更低((15.3±6.4)g/L 比(20.1±7.5)g/L,t = 3.117,P = 0.01),阿片类药物用量更低((160.5±29.3)mg 比(186.1±46.8)mg,t = 2.969,P = 0.01),住院时间更短((7.0±2.0)d 比(10.0±2.5)d,t = -6.000,P = 0.01)。UKA组的遗忘关节评分更高((65.1±7.6)比(58.3±13.9),t = 2.732,P = 0.01),膝关节弹响或摩擦音发生率更低(0.03)。两组手术止血带时间、活动范围、美国膝关节协会临床评分及下肢深静脉血栓形成发生率差异无统计学意义。两组均未发生手术部位感染、假体松动及脱位等并发症。UKA的早期效果与TKA相似,在膝关节弹响或摩擦音、遗忘关节评分、失血、阿片类药物用量及术后住院时间方面优于TKA。