CAJ | 학술논문

目的了解微创小切口技术方法治疗膝关节内侧胫股间室骨关节炎的临床疗效.方法自2007年10月至2010年6月,对22例(25膝)内侧胫股间室重度骨关节炎患者经关节镜探查后,采用微创小切口技术行sledge knee假体UKA手术,并与同期进行的19例(21膝)Gemini MKⅡ假体全膝关节置换术(TKA)治疗组相比较.结果两组术前一般资料比较,差异均无统计学意义(均P＞0.05).与TKA组相比,UKA组的术中出血量更少[(148±26)ml比(278±36) ml],手术时间更短[(68±12) min比(86±12)min],而且患膝关节屈曲达90°的康复进程更快[(3.1±1.8)d比(9.1±2.2)d],首次下床的时间更早[(2.1±1.0)d比(3.8±1.0)d,(P＜ 0.05)].患者术后随访时间为6 ～ 34个月.末次随访时两组的KSS膝评分、KSS功能评分及WOMAC评分相比,差异均无统计学意义(均P ＞0.05).结论与TKA治疗膝关节内侧胫股间室骨关节炎相比,关节镜技术与小切口UKA相结合的疗法组织创伤更小,关节功能康复更快；二者的中期临床疗效无明显差异.
목적 료해미창소절구기술방법치료슬관절내측경고간실골관절염적림상료효.방법 자2007년10월지2010년6월,대22례(25슬)내측경고간실중도골관절염환자경관절경탐사후,채용미창소절구기술행sledge knee가체UKA수술,병여동기진행적19례(21슬)Gemini MKⅡ가체전슬관절치환술(TKA)치료조상비교.결과 량조술전일반자료비교,차이균무통계학의의(균P＞0.05).여TKA조상비,UKA조적술중출혈량경소[(148±26)ml비(278±36) ml],수술시간경단[(68±12) min비(86±12)min],이차환슬관절굴곡체90°적강복진정경쾌[(3.1±1.8)d비(9.1±2.2)d],수차하상적시간경조[(2.1±1.0)d비(3.8±1.0)d,(P＜ 0.05)].환자술후수방시간위6 ～ 34개월.말차수방시량조적KSS슬평분、KSS공능평분급WOMAC평분상비,차이균무통계학의의(균P ＞0.05).결론 여TKA치료슬관절내측경고간실골관절염상비,관절경기술여소절구UKA상결합적요법조직창상경소,관절공능강복경쾌；이자적중기림상료효무명현차이.
Objective To compare the clinical efficacies of two surgical methods in the treatment of medial tibil-femoral osteoarthritis.Methods Between October 2007 and June 2010,a total of 22 cases (25 knees) with severe osteoarthritis in medial tibial-femoral compartment underwent minimally invasive unicompartmental knee arthroplasty (UKA) with Sled prosthesis after arthroscopic procedure. And its clinical efficacy was compared with that of 22 cases ( 25 knees) undergoing total knee arthroplasty (TKA)with Gemini MK Ⅱ prosthesis almost simultaneously. Results There were no significant difference in general data between 2 groups( P ＞ 0.05 ).Compared with the TKA group,the UKA group had a smaller blood loss (( 148 ±26) vs (278 ±36) ml),a shorter operative duration ((68 ± 12) vs (86± 12) min),a faster progress of resuming 90 ° flexation ( (3.1 ± 1.8 ) vs (9.1 ± 2.2) d) and an earlier off-bed time ( P ＜0.05).All patients were followed up for 6 - 34 months.There was no significant difference in KSS ( Knee Society Score),function score or WOMAC (Western Ontario and McMaster Universities) score between 2 groups at the last follow-up( P ＞ 0.05 ).Conclusion The treatment of medial tibial-femoral osteoarthritis with minimally invasive UKA is superior to that with TKA in that it is less invasive,there is a faster recovery of joint functions and no significant difference exists in the mid-term clinical efficacies between them.