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单髁关节置换术与胫骨高位截骨术之间本体感觉有何差异?一项对同一患者双膝的对比研究。

What is the difference in proprioception between single condylar arthroplasty and high tibial osteotomy? a comparative study on both knees of the same patient.

机构信息

Guangzhou University of Chinese Medicine, The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China.

Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District 22 Baiyun, Guangzhou, 510405, Guangdong, China.

出版信息

J Orthop Surg Res. 2023 Jul 6;18(1):486. doi: 10.1186/s13018-023-03965-5.

Abstract

OBJECTIVE

This study aims to investigate the efficacy and outcomes of different surgical procedures, namely unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO), for the treatment of bilateral medial compartment knee osteoarthritis in the same patient. The joint awareness and function of these two surgical methods were evaluated.

METHODS

A total of 15 patients with bilateral medial compartment knee osteoarthritis who underwent either UKA or HTO between 2012 and 2020 were included in the study. Patient data, including age, gender, body mass index and length of hospital stay, were collected. Pre- and post-operative measurements were conducted, including tibiofemoral angle, tibial plateau posterior inclination angle, proximal tibial medial angle, distance from mechanical axis to knee joint center, hip-knee-ankle angle, pre- and post-operative knee joint scores, knee joint range of motion, and FIS-12 scores at 3, 6, 12, and 24 months postoperatively. The latest follow-up was used for evaluating the outcomes of osteoarthritis treatment. Normality of continuous variables was assessed using the Shapiro-Wilk test. Between-group comparisons were performed using the paired sample t-test or Wilcoxon rank-sum test. Repeated measures analysis of variance was utilized to analyze FJS-12 measurements at different time points, and the correlation between FJS-12 and postoperative clinical results was examined using Pearson's correlation coefficient. Statistical significance was set at P < 0.05.

RESULTS

Significant differences were observed in FJS between the UKA and HTO groups at 3 and 6 months postoperatively, but no significant difference was found at 1 and 2 years postoperatively. FJS in the UKA group demonstrated a significant increase from 3 to 6 months postoperatively, but no significant difference was observed from 6 to 24 months postoperatively. In contrast, FJS in the HTO group showed a significant increase from 3 to 24 months postoperatively.

CONCLUSIONS

Patients who underwent UKA exhibited superior joint awareness compared to those who underwent HTO during the early postoperative period. Furthermore, the rate of joint awareness in UKA patients was faster than in HTO patients.

摘要

目的

本研究旨在探讨单髁膝关节置换术(UKA)和胫骨高位截骨术(HTO)治疗同一患者双侧内侧间室膝骨关节炎的疗效和结果。评估这两种手术方法的关节意识和功能。

方法

共纳入 2012 年至 2020 年间接受 UKA 或 HTO 的 15 例双侧内侧间室膝骨关节炎患者。收集患者的年龄、性别、体重指数和住院时间等数据。进行术前和术后测量,包括胫股角、胫骨平台后倾角、胫骨近端内侧角、机械轴到膝关节中心的距离、髋膝踝角、术前和术后膝关节评分、膝关节活动度以及术后 3、6、12 和 24 个月的 FIS-12 评分。采用最新随访评估骨关节炎治疗结果。采用 Shapiro-Wilk 检验评估连续变量的正态性。采用配对样本 t 检验或 Wilcoxon 秩和检验进行组间比较。采用重复测量方差分析分析不同时间点 FJS-12 测量值,采用 Pearson 相关系数分析 FJS-12 与术后临床结果的相关性。P<0.05 为差异有统计学意义。

结果

UKA 和 HTO 组术后 3 个月和 6 个月时 FJS 差异有统计学意义,但术后 1 年和 2 年时差异无统计学意义。UKA 组术后 3 个月至 6 个月 FJS 显著增加,但 6 个月至 24 个月无显著差异。相反,HTO 组术后 3 个月至 24 个月 FJS 显著增加。

结论

UKA 组患者术后早期关节意识优于 HTO 组,UKA 组患者关节意识恢复速度快于 HTO 组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bc7/10327313/62dc46d4fc54/13018_2023_3965_Fig1_HTML.jpg

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