摘要
Abstract
Objective To explore clinical efficacy of fixed-platform unicompartmental knee arthroplasty(UKA)with bio-logic femoral condyle prosthesis in treating medial compartment osteoarthritis of knee joint.Methods A total of 89 patients with medial compartment osteoarthritis of knee joint who were admitted from January 2021 to December 2023 were selected,and di-vided into biological group and bone cement group according to different treatment methods.There were 45 patients in biologi-cal group,including 18 males and 27 females;aged from 54 to 68 years old with an average of(61.42±6.28)years old;the course of disease ranged from 1 to 5 months with an average of(3.74±0.52)months;28 patients with grade Ⅱ and 17 patients with grade Ⅲ according to Kellgren-Lawrence(K-L)classification;biological femoral head prosthesis was used.There were 44 patients in bone cement group,including 20 males and 24 females;aged from 52 to 69 years old with an average of(61.59±6.18)years old;the course of disease ranged from 0 to 6 months with an average of(3.80±0.49)months;28 patients with grade Ⅱ and 16 patients with grade Ⅲ according to K-L classification;bone cement type femoral head prosthesis was used.Operative time,intraoperative blood loss,intraoperative tourniquet usage time,postoperative drainage volume,hospital stay,and compli-cations between two groups were compared.The changes of Oxford University knee score(OKS),Western Ontario and McMas-ter Universities osteoarthritis index(WOMAC),and knee joint range of motion(ROM)between two groups before operation and after operation at 1,3,and 6 months,visual analogue scale(VAS)before operation and after operation at 1,3,6 and 12 months were used to evaluate pain relief,changes of type Ⅰ collagen carboxy-terminal peptideβ-specific sequence(β-CTX),total N-terminal propeptide of type Ⅰ procollagen(tP Ⅰ NP),and intact parathyroid hormone(iPTH)between two groups before opera-tion and 6 months after operation were compared between two groups.Results The usage time of hemostatic band during opera-tion and hospital stay in biological group were(54.23±5.69)min and(13.13±1.36)days respectively,while those in bone ce-ment group were(62.11±6.34)min and(10.02±1.27)days respectively;there were statistically significant differences between two groups(P＜0.05).There were no statistically significant differences in operation time,intraoperative blood loss,and postop-erative drainage volume between two groups(P＞0.05).Postoperative OKS and WOMAC scores of biological group at 3 and 6 months were(21.13±2.45),(19.44±1.98),(25.14±2.65),(20.23±2.16)points respectively,which were all lower than those of cement group(24.83±2.57),(23.15±2.46),(29.33±2.98),(24.55±2.67)points;ROM was(119.42±12.57)° and(128.56±13.15)°,which were greater than those of cement group(112.34±12.58)° and(120.44±12.73)°;there were statistically signif-icant differences between two groups(P＜0.05).Postoperative VAS of biological group at 1 and 3 months were(2.23±0.24)and(1.92±0.23)respectively,which were higher than those of cement group(1.87±0.21)and(1.67±0.18),and the differences were statistically significant(P＜0.05);however,there were no statistically significant differences in postoperative VAS between two groups at 6 and 12 months(P＞0.05).At six months after operation,there were no significant differences inβ-CTX,tP Ⅰ NP,and iPTH between two groups(P＞0.05).There were no occurrences of implant-related complications such as sterile loos-ening or radiolucent lines of the prosthesis in both groups.Conclusion For the treatment of medial compartment osteoarthritis of knee joint with fixed-platform unicompartmental knee arthroplasty(UKA)with biologic femoral condyle prosthesis,bone ce-ment type femoral condyle prosthesis results in less pain in the short term,while biological type femoral condyle prosthesis has a more advantageous long-term effect,which could improve knee joint function.Clinically,the type of prosthesis could be se-lected based on individual circumstances.关键词
膝骨关节炎/内侧间室/固定平台/单髁置换术/生物型股骨髁假体Key words
Knee osteoarthritis/Medial compartment/Fixed platform/Unicompartmental knee arthroplasty/Bi-ologic femoral condylar prosthesis分类
医药卫生
