不同时期膝关节镜检+单髁关节置换对前内侧间室膝关节骨性关节炎患者膝关节功能的影响

Effects of knee arthroscopy and unicondylar joint replacement in different periods on knee joint function in patients with knee osteoarthritis of the anterior medial compartment

摘要:

目的 研究不同时期膝关节镜检+单髁关节置换对前内侧间室膝关节骨性关节炎患者膝关节功能的影响。方法 回顾性分析2015年10月－2019年10月该院收治的100例前内侧间室膝关节骨性关节炎患者的临床资料，所有患者均行膝关节镜检+单髁关节置换。其中，56例行同期手术治疗的患者作为观察组（Outerbridge分级为Ⅲ级或Ⅳ级），44例行分期手术治疗的患者作为对照组（Outerbridge分级为Ⅰ级或Ⅱ级）。比较两组患者的临床疗效、手术相关指标、治疗前及治疗后3、6和12个月的膝关节活动度、治疗前后膝关节功能评分［疼痛视觉模拟评分（VAS）、牛津大学膝关节评分（OKS）和美国西安大略和麦克马斯特大学骨性关节炎指数（WOMAC）评分］，以及术后并发症发生情况。结果 观察组总有效率为94.64%，与对照组的88.64%比较，差异无统计学意义（P > 0.05）。观察组手术时间和住院时间短于对照组，差异有统计学意义（P < 0.05）。两组患者治疗后3、6和12个月膝关节活动度较治疗前增大，差异有统计学意义（P < 0.05），但不同时期组间比较，差异无统计学意义（P > 0.05）。两组患者治疗后VAS、OKS和WOMAC评分较治疗前降低（P < 0.05）；观察组治疗后WOMAC和OKS评分较对照组低（P < 0.05）；两组患者VAS比较，差异无统计学意义（P > 0.05）。患者均未发生严重并发症，两组患者并发症发生率比较，差异无统计学意义（P > 0.05）。结论 同期与分期行膝关节镜检+单髁关节置换治疗前内侧间室膝关节骨性关节炎，临床疗效相当，但同期膝关节镜检 + 单踝关节置换可促进膝关节功能恢复，值得临床推广。

Abstract:

Objective To study the effect of knee arthroscopy+unicondylar joint replacement on knee joint function in patients with anteromedial compartment knee osteoarthritis in different periods.Methods A retrospective analysis of the clinical data of 100 patients with anteromedial compartment knee osteoarthritis from October 2015 to October 2019. All the patients underwent knee arthroscopy+unicondylar joint replacement, of which 56 patients underwent concurrent treatment was the observation group (Outerbridge grading were Ⅲ～Ⅳ level), and 44 patients underwent staged treatment as the control group (Outerbridge grading were Ⅰ to Ⅱ level). Compared the clinical efficacy and clinical indicators of the two groups, compared the knee joint range of motion before treatment and 3, 6, and 12 months after treatment, and analyzed the knee function scores of the two groups before and after treatment [pain visual analogue scale (VAS), Oxford knee score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score] changes, and compared the postoperative complications of the two groups.Results The total effective rate of the observation group was 94.64%, which was not statistically different from 88.64% of the control group (P > 0.05). The operation time and hospital stay in the observation group were shorter than those in the control group (P < 0.05). 3, 6 and 12 months after treatment in the two groups, the range of motion of the knee joint was higher than that before treatment (P < 0.05), however, there were no significant difference between the two groups (P > 0.05). Compared with before treatment, the VAS, OKS and WOMAC score in the two groups were decreased after treatment (P < 0.05); Compared with the control group, the WOMAC and OKS score in the observation group were lower than those after treatment (P < 0.05); The VAS was compared between the two groups, the difference was not statistically significant (P > 0.05). No serious complications occurred in the two group, and there was no statistical significance in the incidence of complications between the two groups (P > 0.05).Conclusion In the same period and staged knee arthroscopy+unicondylar joint replacement, the effect of knee osteoarthritis patients with the anterior medial compartment is equivalent, however, simultaneous knee arthroscopy combined with unicondylar jiont replacement can promote the recovery of knee joint function, which is worthy of promotion.