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微创小切口入路与髌旁内侧入路在全膝关节置换术中的比较:采用遗忘关节评分测量的患者报告结局的差异。

Mini-midvastus versus medial parapatellar approach in total knee arthroplasty: difference in patient-reported outcomes measured with the Forgotten Joint Score.

机构信息

Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

J Orthop Surg Res. 2020 Aug 17;15(1):336. doi: 10.1186/s13018-020-01869-2.

Abstract

BACKGROUND

Low knee awareness after minimally invasive total knee arthroplasty (TKA) has become the ultimate target of a natural-feeling knee that meets patient expectations. The objective of this research was to compare the clinical outcomes of TKA via the mini-midvastus (MMV) approach or the medial parapatellar (MPP) approach, and to evaluate which approach can lead to a better quality of life after surgery.

METHODS

From January 2015 to December 2016, a retrospective cohort study was conducted in 330 patients who underwent TKA via a mini-midvastus (MMV) approach. During this period, we also selected 330 patients who underwent TKA via a medial parapatellar (MPP) approach (MPP group) for comparison. Clinical results were assessed with the visual analog scale score for pain, range of motion, and the Knee Society Score. The Forgotten Joint Score was used to analyze the ability to forget the joint.

RESULTS

There were significant differences with regard to visual analog scale score, range of motion, and the Knee Society Score until 6 months after surgery between the MMV and MPP groups (p < 0.05), but the differences were not significant at 12 months, 24 months, and 36 months after surgery. However, there were significant differences in the Forgotten Joint Score between the groups during the follow-up period (p < 0.05).

CONCLUSION

When forgetting the artificial joint after TKA is the ultimate target, better quality of life can be acquired by performing TKA via the MMV approach. In addition, compared with the MPP approach, the MMV approach can offer less pain and a faster recovery.

摘要

背景

微创全膝关节置换术(TKA)后膝关节感觉降低已成为满足患者期望的自然感觉膝关节的最终目标。本研究旨在比较微创中间(MMV)入路与经内侧髌旁(MPP)入路 TKA 的临床疗效,并评估哪种方法能在术后带来更好的生活质量。

方法

回顾性分析 2015 年 1 月至 2016 年 12 月期间采用微创中间(MMV)入路行 TKA 的 330 例患者(MMV 组)的临床资料,同期选取 330 例采用经内侧髌旁(MPP)入路行 TKA 的患者(MPP 组)作为对照组。采用视觉模拟评分(VAS)评估疼痛,采用膝关节活动度评估膝关节功能,采用膝关节学会评分(KSS)评估膝关节功能。采用遗忘关节评分(FJS)评估患者对膝关节的遗忘程度。

结果

两组患者术后 6 个月的 VAS 评分、膝关节活动度及 KSS 评分差异均有统计学意义(p < 0.05),但术后 12 个月、24 个月、36 个月时差异无统计学意义。而两组患者的 FJS 评分在随访期间差异有统计学意义(p < 0.05)。

结论

当 TKA 后遗忘人工关节成为最终目标时,采用 MMV 入路行 TKA 可获得更好的生活质量。与 MPP 入路相比,MMV 入路可减轻术后疼痛,加快术后康复。

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