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中国 80 岁以上接受牛津单髁膝关节置换术的前内侧骨关节炎患者的治疗效果。

Patient outcomes in Anteromedial osteoarthritis patients over 80 years old undergoing Oxford Unicompartmental knee Arthroplasty in China.

机构信息

Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, Changchun Ave 45, Xicheng District, Beijing, 100053, China.

出版信息

BMC Musculoskelet Disord. 2020 Jul 8;21(1):446. doi: 10.1186/s12891-020-03474-0.

Abstract

BACKGROUND

The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly in both Western and Asian populations, with excellent functional outcomes and high patient satisfaction. While previous evidence regarding clinical outcomes and survival rates after Oxford UKA was based on studies in Western populations, the results may be different in Asian patients. The relevance of age for postoperative function after Oxford UKA also remains unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years.

METHODS

A retrospective review was performed and included 195 patients (209 knees) who underwent an Oxford UKA between June 2015 and July 2018. We divided the patients into three groups by age: Group 1, 60-69 years; Group 2, 70-79 years; and Group 3, over 80 years. We used the Hospital for Special Surgery (HSS) score and Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index score to evaluate the general condition of the patients' knees before surgery and at last follow-up. We also recorded perioperative and short-term complications.

RESULT

Group 1 consisted of 60 patients (60 knees); Group 2, 70 patients (79 knees); and Group 3, 65 patients (70 knees). The mean follow-up was 21.34 ± 12.04, 22.08 ± 11.38, and 21.76 ± 10.20 months in groups 1, 2, and 3, respectively. At last follow-up, the patients in Group 3 showed lower function scores compared to groups 1 and 2 (P < 0.05), but the HSS scores and the WOMAC scores were significantly improved in all three groups. In terms of perioperative and other complications, the three age groups did not differ significantly.

CONCLUSION

Oxford UKA is an effective and safe treatment for osteoarthritis, even in elderly patients in China. Elderly patients have lower knee function scores than younger patients. However, the knee joint pain of the elderly patients was relieved and function improved compared to the preoperative condition.

摘要

背景

在西方和亚洲人群中,牛津单髁膝关节置换术(UKA)的应用迅速增加,具有出色的功能结果和高患者满意度。虽然牛津 UKA 术后临床结果和生存率的先前证据基于西方人群的研究,但结果在亚洲患者中可能有所不同。牛津 UKA 术后功能与年龄的相关性也尚不清楚。因此,我们的研究目的是明确牛津 UKA 在 80 岁以上亚洲患者中的有效性和安全性。

方法

回顾性分析了 2015 年 6 月至 2018 年 7 月期间接受牛津 UKA 的 195 例患者(209 膝)。我们将患者按年龄分为三组:第 1 组,60-69 岁;第 2 组,70-79 岁;第 3 组,80 岁以上。我们使用美国特种外科医院(HSS)评分和西部安大略省和麦克马斯特大学(WOMAC)骨关节炎指数评分来评估患者术前和末次随访时膝关节的一般状况。我们还记录了围手术期和短期并发症。

结果

第 1 组有 60 例患者(60 膝);第 2 组有 70 例患者(79 膝);第 3 组有 65 例患者(70 膝)。第 1、2 和 3 组的平均随访时间分别为 21.34±12.04、22.08±11.38 和 21.76±10.20 个月。末次随访时,第 3 组患者的功能评分明显低于第 1 组和第 2 组(P<0.05),但三组的 HSS 评分和 WOMAC 评分均明显改善。在围手术期和其他并发症方面,三个年龄组之间无显著差异。

结论

即使在中国的老年患者中,牛津 UKA 也是治疗骨关节炎的一种有效且安全的方法。老年患者的膝关节功能评分低于年轻患者。然而,与术前相比,老年患者的膝关节疼痛得到缓解,功能得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a50/7346402/54ffd8d69632/12891_2020_3474_Fig1_HTML.jpg

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