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在同一患者中同时进行的两种膝关节置换技术(全膝关节置换术和单髁膝关节置换术)治疗骨关节炎的功能结果比较

Comparison of Functional Outcomes of Two Knee Arthroplasty Techniques (Total Knee Arthroplasty and Unicompartmental Knee Arthroplasty) for the Treatment of Osteoarthritis, simultaneously done in the Same Patients.

作者信息

Latifpoor Mohsen, Sarzaeem Mohammad Mahdi, Amouzadeh Omrani Farzad, Raissi Dehkordi Sina

出版信息

Arch Bone Jt Surg. 2024;12(10):695-700. doi: 10.22038/ABJS.2024.75050.3469.

DOI:10.22038/ABJS.2024.75050.3469
PMID:39478838
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11519422/
Abstract

OBJECTIVES

This study aims to provide a comprehensive comparative analysis of functional outcomes between Unicompartmental Knee Arthroplasty (UKA) and Total Knee Arthroplasty (TKA) in patients diagnosed with bilateral knee osteoarthritis. Both procedures were performed simultaneously on separate knees to evaluate their respective efficacy.

METHODS

The study included 25 patients (18 women and 7 men) with a mean age of 59.6 years, all meeting the criteria for administering UKA on one knee and TKA on the other. Radiographic and clinical data were collected over a two-year period, with assessments conducted at 6 months, 1 year, and 2 years postoperatively. Data included age, gender, and body mass index, medical history, surgical procedures, and various scores and measurements related to knee function.

RESULTS

The UKA group exhibited significant improvements in functional scores compared to the TKA group. Specifically, the Western Ontario and McMaster Universities Osteoarthritis Index score for the UKA knee was 24.5% higher than that of the TKA knee, indicating better functional outcomes. Radiographically, the tibio-femoral angle was more than two times greater in the UKA method, while the Varus angle was significantly greater in the TKA method. No post-operative complications were reported.

CONCLUSION

This study underscored the safety and efficacy of both UKA and TKA procedures in the treatment of bilateral knee osteoarthritis. UKA demonstrated superior functional outcomes, while TKA displayed distinct advantages in radiographic alignment. Individual patient characteristics and preferences should guide the selection of the most appropriate surgical approach.

摘要

目的

本研究旨在对诊断为双侧膝关节骨关节炎的患者进行单髁膝关节置换术(UKA)和全膝关节置换术(TKA)后的功能结局进行全面的比较分析。两种手术分别在不同的膝关节上同时进行,以评估各自的疗效。

方法

该研究纳入了25例患者(18例女性和7例男性),平均年龄59.6岁,所有患者均符合一侧膝关节行UKA而另一侧行TKA的标准。在两年时间内收集影像学和临床数据,术后6个月、1年和2年进行评估。数据包括年龄、性别、体重指数、病史、手术方式以及与膝关节功能相关的各种评分和测量结果。

结果

与TKA组相比,UKA组的功能评分有显著改善。具体而言,UKA膝关节的西安大略和麦克马斯特大学骨关节炎指数评分比TKA膝关节高24.5%,表明功能结局更好。影像学上,UKA方法的胫股角比TKA方法大两倍多,而TKA方法的内翻角明显更大。未报告术后并发症。

结论

本研究强调了UKA和TKA手术在治疗双侧膝关节骨关节炎方面的安全性和有效性。UKA显示出更好的功能结局,而TKA在影像学对线方面具有明显优势。应根据个体患者的特征和偏好来指导选择最合适的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/46bf0d7823eb/ABJS-12-695-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/529230ca8105/ABJS-12-695-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/4709f611462a/ABJS-12-695-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/46bf0d7823eb/ABJS-12-695-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/529230ca8105/ABJS-12-695-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/4709f611462a/ABJS-12-695-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843e/11519422/46bf0d7823eb/ABJS-12-695-g003.jpg

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本文引用的文献

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Arch Bone Jt Surg. 2023;11(5):326-329. doi: 10.22038/ABJS.2023.66905.3186.
2
Obesity increases the risk of conversion to total knee arthroplasty after unicompartimental knee arthroplasty: a meta-analysis.肥胖增加了单髁膝关节置换术后全膝关节置换术的转化率:一项荟萃分析。
Knee Surg Sports Traumatol Arthrosc. 2022 Dec;30(12):3945-3957. doi: 10.1007/s00167-021-06780-9. Epub 2021 Oct 31.
3
Is postoperative flexion angle genuinely better in unicompartmental knee arthroplasty than in total knee arthroplasty? A comparison between the knees in the same patients.
单髁膝关节置换术后的屈膝角度真的比全膝关节置换术更好吗?同一患者膝关节的比较。
Knee. 2020 Dec;27(6):1907-1913. doi: 10.1016/j.knee.2020.09.011. Epub 2020 Nov 18.
4
Pain management of unicompartmental (UKA) vs. total knee arthroplasty (TKA) based on a matched pair analysis of 4144 cases.基于 4144 例配对分析的单髁膝关节置换术(UKA)与全膝关节置换术(TKA)的疼痛管理比较。
Sci Rep. 2020 Oct 19;10(1):17660. doi: 10.1038/s41598-020-74986-x.
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Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations.膝骨关节炎:发病机制及最新非手术治疗方法综述。
Genes (Basel). 2020 Jul 26;11(8):854. doi: 10.3390/genes11080854.
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Medicine (Baltimore). 2018 May;97(21):e10828. doi: 10.1097/MD.0000000000010828.
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