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同一患者行单髁膝关节置换术与全膝关节置换术的临床结果。

Clinical outcomes of unicompartmental knee arthroplasty and total knee arthroplasty in the same patient.

机构信息

Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, NO. 89 Donggang Road, Shijiazhuang, 050030, P.R. China.

出版信息

Arch Orthop Trauma Surg. 2024 Nov;144(11):4791-4800. doi: 10.1007/s00402-024-05564-3. Epub 2024 Sep 23.

Abstract

BACKGROUND

Osteoarthritis has become the predominant manifestation of arthritic conditions on a worldwide scale and serves as a significant instigator of pain, impairment, and increasing socio-economic strain on a global level. The ongoing discourse on the choice between total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) for patients suffering from anterior medial osteoarthritis continues to ignite scholarly controversy. Our objective was to assess and compare the clinical outcomes of UKA and TKA within the same patient, hereby offering a novel perspective on this topic.

MATERIALS AND METHODS

Fifty-seven individuals who underwent TKA on one knee and UKA on the other knee at the Department of Orthopaedics, First Hospital of Hebei Medical University between March 2019 and March 2024 were analysed for this retrospective study. We conducted a comprehensive examination and evaluation of perioperative laboratory assessments, radiological examinations, knee functionality, contentment levels, and postoperative complications within the two groups.

RESULTS

Following surgical procedures, levels of hemoglobin, red blood cells, and albumin were found to be elevated in the UKA group when compared to the TKA group (hemoglobin: 121.2 ± 12.54 vs. 110.1 ± 13.21 g/L; red blood cells: 4.0 ± 0.47 vs. 3.6 ± 0.42 *10/L; albumin: 37.7 ± 5.66 vs. 35.3 ± 5.23 g/L). There is a significant difference in the hip-knee-ankle angles between the postoperative UKA group and the TKA group (5.3 ± 3.46° vs. 4.1 ± 2.86°, p < 0.05). There existed no notable disparity in postoperative visual analog scale, knee society score, and forgotten joint score between the two groups. However, a remarkable variance was observed in postoperative range of motion between the two groups (116.4 ± 5.96° vs. 108.4 ± 5.32°).

CONCLUSION

We found that UKA resulted in less physical strain, less postoperative inflammatory response, improved joint mobility, although with less effective lower limb force line correction compared to TKA. Many patients have shown a preference for UKA and express higher levels of satisfaction with the procedure.

摘要

背景

骨关节炎已成为全球范围内关节炎疾病的主要表现形式,也是导致疼痛、功能障碍以及全球范围内社会经济负担不断增加的重要因素。对于患有前内侧骨关节炎的患者,全膝关节置换术(TKA)和单髁膝关节置换术(UKA)之间的选择一直是学术争论的焦点。我们的目的是评估和比较同一患者中 UKA 和 TKA 的临床结果,从而为该主题提供新的视角。

材料和方法

本回顾性研究分析了 2019 年 3 月至 2024 年 3 月在河北医科大学第一医院骨科接受单侧 TKA 和另一侧 UKA 的 57 名患者。我们对两组患者的围手术期实验室评估、影像学检查、膝关节功能、满意度水平和术后并发症进行了全面检查和评估。

结果

与 TKA 组相比,UKA 组术后血红蛋白、红细胞和白蛋白水平升高(血红蛋白:121.2±12.54 与 110.1±13.21 g/L;红细胞:4.0±0.47 与 3.6±0.42*10/L;白蛋白:37.7±5.66 与 35.3±5.23 g/L)。UKA 组与 TKA 组术后髋膝踝角存在显著差异(5.3±3.46°与 4.1±2.86°,p<0.05)。两组术后视觉模拟评分、膝关节协会评分和遗忘关节评分无显著差异。然而,两组术后活动范围存在显著差异(116.4±5.96°与 108.4±5.32°)。

结论

与 TKA 相比,UKA 导致的身体负担较小,术后炎症反应较轻,关节活动度改善,但下肢力线矫正效果较差。许多患者更喜欢 UKA,对手术的满意度更高。

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