单髁置换与全膝关节置换治疗内侧胫股关节炎早中期疗效比较

单髁置换术与膝关节置换术的区别？单髁置换有哪些优势？-健康百科在关节外科门诊，我们遇到很多膝关节炎患者，来看病或是由儿女扶着，或是坐着轮椅。

其实，如果能早点治疗，情况可能完全不一样。

关于“膝关节骨性关节炎”你所需要知道的膝关节骨性关节炎是中老年发生的一种常见慢性关节炎，又称退行性膝骨关节病，是中老年人常见的腿痛病原因之一，随着人口老常龄化，该病发病率很高：30-45岁约5%45-65岁约50%70岁以后约80%简单说来，这个病是因为膝关节长期磨损所出现的老化。

随着不同的阶段，其症状表现轻重不一。

早期多为轻微的行走不适感、上下台阶及行走疼痛;中期的表现多为走平路即出现膝关节局部的肿痛不适、伴有轻度的畸形、行走距离明显缩短;晚期则表现为膝关节明显的各式各样的畸形、静息时疼痛不适、非负重的屈伸活动受限、行走距离很短甚至最后丧失行动能力、残废。

关于膝关节骨性关节炎的治疗方法，按照骨性关节炎发病程度及阶段不同，可以采用不同的方法来治疗。

膝关节疾病在老年人中非常常见，需要换或者已经换了膝关节的中老年人不在少数。

然而，并不是所有的人都需要把整个膝关节全部换掉。

有些病人，只需要置换关节的一部分。

什么是“膝关节单髁置换术”简单来说，人体膝关节分为三个间室，分别为内侧间室、外侧间室、髌股间室。

膝退行性关节炎可以影响其中任何一个间室，1/3的膝关节炎病人早期病变仅局限于内侧间室。

这类患者经常会感到膝关节内侧疼痛，站立和行走后尤为明显。

如果采取全膝关节置换术，会使病人失去正常或者近乎正常的关节面软骨及韧带，创伤过大，对另外两个正常的间室来说是一种极大的浪费和不公。

膝关节单髁置换术就是针对这类患者所设计的，通过更加精准和微创的手术仅对单间室磨损软骨面置换，保留正常关节韧带、软骨等固有的内在结构，病人术后更容易感知关节活动过程中位置及力量变化，关节活动范围接近正常，在经过康复训练后，更容易“遗忘”手术，运动更加协调、自如。

单髁膝关节置换术与全膝关节置换术治疗膝关节内侧单间室退变的疗效对比分析目的分析單髁关节置换术和全膝关节置换术治疗膝关节内侧单间室退变的临床效果。

方法将2014年8月～2016年11月在我院接受治疗的40例膝关节内侧单间室退变患者资料进行研究；随机将患者分为观察组和对照组，每组20例；观察组行单髁膝关节置换术治疗，对照组行全膝关节置换术治疗，比较两组的疗效。

结果经治疗，观察组手术相关指标（切口长度、手术时间、术中失血量、住院时间）均优于对照组（P＜0.05）。

观察组术后2 w功能评分（HSS）及膝关节屈伸活动度评分（ROM）、生活质量评分（SF-36）及疼痛评分（V AS）均优于对照组（P＜0.05），术后3个月两项评分无统计学差异（P>0.05）。

随访提示，两组患者均未出现程度严重的并发症，观察组并发症率10.00%（2/20），对照组并发症率15.00%（3/20），两数据无统计学差异（P>0.05）。

结论单髁关节置换术和全膝关节置换术治疗膝关节内侧单间室退变均具有较好的临床效果，但相比而言单髁膝关节置换术的创伤更小、手术时间更短，近期疗效更好，可在临床中优先使用。

Abstract：Objective To analyze the clinical effect of single condylar arthroplasty and total knee arthroplasty in the treatment of medial interventricular degeneration of the knee.Methods 40 patients with medial interventricular degeneration were treated in our hospital from August 2014 to November 2016.The patients were randomly divided into observation group and control group（n=20）.The observation group underwent unicompartmental knee replacement therapy，the control group underwent total knee arthroplasty，the curative effect was compared between the two groups.Results After treatment，observation group surgery related index（length of incision，operative time，intraoperative blood loss，hospitalization time）were better than the control group（P＜0.05）.The postoperative 2 w functional score（HSS）and knee flexion and extension scale（ROM），The quality of life score （SF-36）and pain score（V AS）were better than those in the control group（P＜0.05）.3 months after surgery，two were no significant difference（P> 0.05）.The follow-up indicated that serious complications were not found in two patients，the observation group complication rate was 10.00%（2/20），the control group complication rate was 15.00%（3/20），no significant difference between the two data（P>0.05）.Conclusion Unicompartmental knee arthroplasty and total knee arthroplasty in treatment of knee joint medial unicompartment degeneration has good clinical effect，but compared with unicompartmental knee arthroplasty has less trauma，shorter operation time，better curative effect，can be used in clinic.Key words：Medial compartment degeneration of the knee joint；Single condylar joint replacement；Total knee arthroplasty；Complications随着中老年人口比重的增长，膝关节退变性疾病的发生率逐年提升，据权威统计资料显示，内侧间室退变病例占所有膝关节退变性疾病的80%～90%[1]，疾病的治疗也成为骨科临床的热点问题之一。

系统医学2021年4月第6卷第8期DOI:10.19368/ki.2096-1782.2021.08.044单髁置换术与全膝关节置换术治疗膝单间室骨性关节炎近中期效果比较分析张伟■>,陆林21.长春市中心医院骨科，吉林长春130051；2.长春市中心医院医务科，吉林长春130051［摘要］目的分析膝单间室骨性关节炎的治疗中实施单課置换术与全膝关节置换术的近中期临床效果。

方法选入该院于2017年4月一2018年5月期间进行治疗的膝单间室骨性关节炎患者100例，以随机数表法的形式将其平均分为研究组和参照组，各为50例。

参照组行全膝关节置换术，研究组行单課置换术,对比手术后两组治疗效果、手术前后两组膝关节功能评分以及膝关节屈曲角度的变化，以及手术中的出血量和手术后3d血红蛋白的下降量。

结果研究组的手术优良率94.00%高于参照组，差异有统计学意义(x2=4.332,P<0.05)。

且术后，研究组患者的膝关节功能评分以及膝关节屈曲角度的变化均比参照组理想，术中出血量和术后3d血红蛋白的下降量低于参照组，差异有统计学意义(P<0.05)。

结论对于膝单间室骨性关节炎患者而言，采用单課置换术治疗，治疗效果更为理想，创伤较小，缩减了手术的出血量,更有助于膝关节各项功能的恢复。

［关键词］单髁置换术;全膝关节置换术;膝单间室骨性关节炎；临床效果［中图分类号］R687［文献标识码］A［文章编号］2096-1782(2021)04(b)-0044-03A Comparative Analysis of the Effects of Unicompartmental Arthroplastyand Total Knee Arthroplasty in the Treatment of Unicompartmental Knee Osteoarthritis in the Near and Mid-termZHANG Wei1,LU Lin21.Department of Orthopedics,Changchun Central Hospital,Changchun,Jilin Province,130051China;2.Department ofMedical Affairs,Changchun Central Hospital,Changchun,Jilin Province,130051China［Abstract］Objective To analyze the clinical effects of unicompartmental arthroplasty and total knee arthroplasty in the treatment of unicompartmental knee osteoarthritis.Methods A total of100patients with knee unicompartment osteoarthritis who were treated in the hospital from April2017to May2018were selected and divided into the study group and the reference group in the form of a random number table,50cases each.The reference group underwent total knee arthroplasty,and the study group underwent single condyle replacement.The treatment effects of the two groups after the operation,the knee function scores of the two groups before and after the operation and the changes in knee flexion angle,as well as the amount of blood loss and postoperative decrease in hemoglobin in3d were compared.Results The excellent and good rate of operation in the study group was94.00%higher than that in the reference group,the difference was statistically significant(x2=4.332,P<0.05).After the operation,the knee function scores and the changes in knee flexion angle of the study group were better than those in the reference group,the intraoperative blood loss and the decrease in hemoglobin3d after surgery were lower than those in the reference group.The difference was statistically significant(P<0.05).Conclusion For patients with unicompartmental knee osteoarthritis, unicompartmental replacement surgery has a better therapeutic effect,less trauma,reduced surgical bleeding,and is more helpful to the recovery of various knee joint functions.［Key words］Unicondyle replacement;Total knee replacement;Single-compartment knee osteoarthritis;Clinical effect膝单间室骨性关节炎作为常见的慢性老年骨科疾病,一般以中老年人为主要的发病群体，且随着国内人口的老龄化，患病人数在不断增加。

- 141 -①无锡市惠山区人民医院　江苏　无锡　214000通信作者：储旭东膝关节单髁置换术与全膝关节置换术治疗膝内侧单间室骨关节炎的效果钱春晓①　唐晔①　过锡民①　储旭东①【摘要】　目的：探讨膝关节单髁置换术（UKA）与全膝关节置换术（TKA）治疗膝内侧单间室骨关节炎的效果。

方法：回顾性分析2019年3月—2022年12月无锡市惠山区人民医院收治的107例膝内侧单间室骨关节炎患者的临床资料。

根据手术方法的不同将其分为对照组（62例）与观察组（45例）。

对照组行TKA 治疗，观察组行UKA 治疗。

比较两组围手术期指标，临床疗效，术前及术后3 d 膝关节疼痛，术前及术后1个月膝关节功能及并发症。

结果：观察组手术时间、自主屈膝90° 所用时间、住院时间均显著短于对照组，术中出血量少于对照组，差异有统计学意义（P <0.05）。

观察组优良率显著高于对照组，差异有统计学意义（P <0.05）。

术后3 d，观察组视觉模拟评分法（VAS）评分显著低于对照组，术后1个月，观察组美国特种外科医院（HSS）评分高于对照组，差异有统计学意义（P <0.05）。

观察组并发症发生率显著低于对照组，差异有统计学意义（P <0.05）。

结论：UKA 相较TKA 在治疗膝内侧单间室骨关节炎时，手术时间短，出血量少，住院时间短，疼痛轻和并发症率低，且功能恢复更好。

【关键词】　膝关节单髁置换术　全膝关节置换术　膝内侧单间室骨关节炎　临床疗效　膝关节功能 doi：10.14033/ki.cfmr.2023.30.035 文献标识码　B 文章编号　1674-6805（2023）30-0141-05 Efficacy of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty in the Treatment of Knee Inside Single Compartment Osteoarthritis/QIAN Chunxiao, TANG Ye, GUO Ximin, CHU Xudong. //Chinese and Foreign Medical Research, 2023, 21(30): 141-145 [Abstract]　Objective: To investigate the efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in the treatment of knee inside single compartment osteoarthritis. Method: The clinical data of 107 patients with knee inside single compartment osteoarthritis admitted to People's Hospital of Huishan District, Wuxi City from March 2019 to December 2022 were retrospectively analyzed. They were divided into control group (62 cases) and observation group (45 cases) according to different surgical methods. The control group received TKA treatment, and the observation group received UKA treatment. Perioperative indexes, clinical efficacy, knee joint pain before and 3 d after surgery, knee joint function before and 1 month after surgery and complications were compared between the two groups. Result: The surgery time, the time spent on voluntary knee bending 90° and the hospital stay in the observation group were significantly shorter than those in the control group, and the intraoperative blood loss volume was less than that in the control group, the differences were statistically significant (P <0.05). The excellent and good rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P <0.05). The visual analogue scale (VAS) score of the observation group was significantly lower than that of the control group at 3 d after surgery, and the hospital for special surgery (HSS) score of the observation group was higher than that of the control group at 1 month after surgery, the differences were statistically significant (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion: Compared with TKA, UKA has shorter surgery time, less blood loss volume, shorter hospital stay, less pain, lower complication incidence in the treatment of knee inside single compartment osteoarthritis, and better functional recovery. [Key words]　Unicompartmental knee arthroplasty　Total knee arthroplasty　Knee inside single compartment osteoarthritis　Clinical efficacy　Knee joint function First-author's address: People's Hospital of Huishan District, Wuxi City, Wuxi 214000, China 随着全球人口老龄化的深入发展，膝骨关节炎的发病率逐年上升，已成为严重威胁中老年人生活质量的主要疾病之一[1]。