中国组织工程研究 ›› 2020, Vol. 24 ›› Issue (6): 827-832.doi: 10.3969/j.issn.2095-4344.2446

• 人工假体 artificial prosthesis • 上一篇    下一篇

单髁与全膝关节置换治疗膝关节单间室骨关节炎的平衡功能评价

谭  彪,左  彪,黄  勇   

  1. 成都中医药大学附属医院,四川省成都市   610075
  • 收稿日期:2019-05-15 修回日期:2019-05-25 接受日期:2019-07-05 出版日期:2020-02-28 发布日期:2020-01-16
  • 通讯作者: 黄勇,博士,主任医师,成都中医药大学附属医院,四川省成都市 610075
  • 作者简介:谭彪,男,1992年生,重庆市人,2019年成都中医药大学临床医学院毕业,硕士,医师,主要从事关节外科与运动医学研究。 共同第一作者:左彪,男,1994年生,四川省人,成都中医药大学在读硕士,医师,主要从事关节外科与运动医学方面的研究。

Evaluation of balance function of unicompartmental and total knee arthroplasties for treating unicompartmental knee osteoarthritis 

Tan Biao, Zuo Biao, Huang Yong   

  1. the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
  • Received:2019-05-15 Revised:2019-05-25 Accepted:2019-07-05 Online:2020-02-28 Published:2020-01-16
  • Contact: Huang Yong, MD, Chief physician, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
  • About author:Tan Biao, Master, Physician, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China Zuo Biao, Master candidate, Physician, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China Tan Biao and Zuo Biao contributed equally to this work.

摘要:

文题释义:
膝关节单侧间室骨关节炎:指症状及影像学表现仅限于单侧间室的膝关节骨性关节炎,临床以膝关节内侧间室病变常见,大约占到所有膝骨关节炎患者的25%。针对此类膝骨关节炎患者,选择何种治疗方式还有较大争议。
膝关节平衡功能:在人体中,平衡功能的保持需要神经、肌肉等共同协调来完成,这个过程需要感觉信号的输入、中枢神经系统对信号的整合、控制运动等方面来完成。膝关节周围的本体感受器包括有关节的位置觉及运动觉,经过中枢神经系统到达关节周围的感觉信号经处理后最终能够对关节的稳定极平衡功能发挥维持和稳定作用。

背景:单纯的单间室膝关节骨关节炎在临床上既可选择全膝关节置换,也可选择部分膝关节置换。在治疗方案的选择上,受到多种因素影响导致差异很大,几乎没有可靠的循证证据来指导临床手术方案的选择。

目的:比较单髁置换与全膝关节置换治疗膝关节单间室骨关节炎的近期疗效,并探究2种治疗方式对患者平衡功能的影响。

方法:采用回顾性研究的方式,将膝关节单间室骨关节炎患者根据不同的手术方式分为2组,单髁置换组22例23膝,全膝关节置换组30例30膝。2组患者对治疗方案均知情同意,且得到医院伦理委员会批准。比较2组患者的手术时间、住院时间及术后美国特种外科医院膝关节评分、膝关节活动度等指标评价早期疗效,并于术前及术后3个月采用Tecnobody本体感觉测试系统及计时起立行走测试、Berg平衡量表评价患者平衡功能。

结果与结论:①与全膝关节置换组相比,单髁置换组的手术时间及住院时间均更短(P < 0.001);②术后3个月,2组患者美国特种外科医院评分、膝关节活动度、计时起立行走测试结果、Berg平衡量表评分比较差异均无显著性意义(P > 0.05);单髁置换组患者术后3个月Tecnobody本体感觉综合评分高于全膝关节置换组,差异有显著性意义(P < 0.001);③提示单髁置换与全膝关节置换治疗膝关节单间室骨关节炎近期疗效均满意,但单髁置换在手术时间、住院时间及患者平衡功能恢复上优于全膝关节置换。

ORCID: 0000-0001-7262-9850(谭彪);0000-0001-5443-6422(左彪)

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

关键词: 单髁置换, 全膝关节置换, 膝关节功能, 活动度, 本体感觉, 平衡功能

Abstract:

BACKGROUND: Unicompartmental knee osteoarthritis can be treated clinically with either total or partial knee arthroplasty. In the choice of treatment methods, a variety of factors lead to significant differences. There is little reliable evidence to guide the clinical surgical options.

OBJECTIVE: To compare the short-term curative effect of unicompartmental and total knee arthroplasties in the treatment of unicompartmental osteoarthritis and to explore the effects of two treatment methods on the balance function of patients.

METHODS: This was a perspective trial. The patients with unicompartmental knee osteoarthritis were divided into unicompartmental knee arthroplasty group (22 cases, 23 knees) and total knee arthroplasty group (30 cases, 30 knees) based on surgical method. All patients signed the informed consents and the study was approved by the hospital ethical committee. The operation time, hospitalization time, Hospital for Special Surgery score, and the range of motion of the knee joint were compared between two groups to evaluate the early efficacy. The patients’ balance function was evaluated using the Tecnobody Proprioception Test System, Timed Up and Go test, and Berg Balance Scale before and 3 months after surgery.

RESULTS AND CONCLUSION: (1) Compared with the total knee arthroplasty group, the unicompartmental knee arthroplasty group had shorter operation time and hospitalization time (P < 0.001). (2) At 3 months after surgery, there was no significant difference in the Hospital for Special Surgery score, range of motion of the knee joint, Timed Up and Go test or Berg Balance Scale score between two groups (P > 0.05). The Tecnobody Proprioception Test System scores at 3 months after surgery in the unicompartmental knee arthroplasty group were significantly higher than those in the total knee arthroplasty group (P < 0.001). (3) These results indicate that both unicompartmental and total knee arthroplasties have satisfactory short-term results in the treatment of unicompartmental knee osteoarthritis. Unicompartmental knee arthroplasty is superior to total knee arthroplasty in terms of operation time, hospitalization time, and balance function recovery.

Key words: unicompartmental knee arthroplasty, total knee arthroplasty, knee joint function, range of motion, proprioception, balance function

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