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同一患者中活动平台单髁膝关节置换术与全膝关节置换术的中期疗效比较

The mid-term outcomes of mobile bearing unicompartmental knee arthroplasty versus total knee arthroplasty in the same patient.

作者信息

Ma Jinlong, Zhang Liang, Wang Cui, Xu Kuishuai, Ren Zhongkai, Wang Tianrui, Zhang Yingze, Zhao Xia, Yu Tengbo

机构信息

Department of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Abdominal Ultrasound, Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Front Surg. 2023 Jan 25;10:1033830. doi: 10.3389/fsurg.2023.1033830. eCollection 2023.

Abstract

OBJECTIVE

To compare the mid-term outcomes of unicompartmental knee arthroplasty (UKA) that was performed in one knee and total knee arthroplasty (TKA) performed in the other knee in the same stage.

METHODS

This is a retrospective study. A total of 63 patients (126 knees) scheduled for one-stage knee surgery due to osteoarthritis of both knees were selected, and all patients underwent one-stage mobile platform UKA and TKA of the other knee. Differences in general clinical data, functional recovery, complications, and prosthesis revision rates were assessed after UKA and TKA, respectively. The evaluation indicators for knee joint function recovery included the hospital for special surgery knee score (HSS), Joint Forgotten Score (JFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Visual analog scale (VAS). Patient preference between UKA and TKA was also recorded.

RESULTS

During a mean follow-up of 76.95 months (range, 65.00 to 87.00 months), there were no significant differences in postoperative complications between the two groups ( = 0.299); however, the prosthesis revision rate was higher in the UKA group than in the TKA group ( = 0.023). The incision length, operation time, blood loss, and postoperative drainage volume in the UKA group were significantly ( < 0.001) lower than those in the TKA group: JFS, ROM, and VAS in the UKA group were higher than those in the TKA group ( < 0.001,  = 0.023,  = 0.032), HSS and KOOS in TKA group were significantly ( < 0.001) higher than those in UKA group. At the last follow-up, 40% and 24% of patients preferred TKA and UKA, respectively.

CONCLUSIONS

TKA was found to be superior to UKA in terms of HSS, KOOS, and VAS, while UKA had more significant advantages in terms of less surgical trauma, better ROM, and higher JFS. Complications were not different between groups, but UKA had a higher rate of prosthesis revision. After a follow-up of at least 5 years, more patients preferred TKA.

摘要

目的

比较同一阶段一侧膝关节进行单髁膝关节置换术(UKA)与另一侧膝关节进行全膝关节置换术(TKA)的中期疗效。

方法

这是一项回顾性研究。选取63例因双膝骨关节炎计划进行一期膝关节手术的患者(126膝),所有患者均接受一期活动平台UKA及另一侧膝关节的TKA。分别评估UKA和TKA后一般临床资料、功能恢复、并发症及假体翻修率的差异。膝关节功能恢复的评估指标包括特种外科医院膝关节评分(HSS)、关节遗忘评分(JFS)、膝关节损伤和骨关节炎转归评分(KOOS)及视觉模拟量表(VAS)。还记录了患者对UKA和TKA的偏好。

结果

平均随访76.95个月(范围65.00至87.00个月),两组术后并发症无显著差异(P = 0.299);然而,UKA组的假体翻修率高于TKA组(P = 0.023)。UKA组的切口长度、手术时间、失血量及术后引流量显著低于TKA组(P < 0.001):UKA组的JFS、ROM及VAS高于TKA组(P < 0.001,P = 0.023,P = 0.032),TKA组的HSS和KOOS显著高于UKA组(P < 0.001)。在最后一次随访时,分别有40%和24%的患者更倾向于TKA和UKA。

结论

在HSS、KOOS和VAS方面,TKA优于UKA,而UKA在手术创伤更小、ROM更好及JFS更高方面具有更显著优势。两组并发症无差异,但UKA的假体翻修率更高。随访至少5年后,更多患者更倾向于TKA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64b9/9905616/0ca438eab4c4/fsurg-10-1033830-g001.jpg

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