CAJ | 학술논문

目的：比较同期双侧与分期双侧关节置换术治疗膝骨关节炎的疗效和安全性。方法：回顾分析2010年4月—2013年6月全膝关节置换术患者43例，分为同期双侧膝关节置换组(同期组, n=20)和分期双侧膝关节置换组(分期组, n=23)，分别对两组患者置换前后的关节活动度(range of motion, ROM)、疼痛视觉模拟评分(visual analogue scale, VAS)、术后并发症、美国膝关节协会评分(American Knee Society Score,简称KSS评分)系统及西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index, WOMAC指数)进行比较分析。结果：两组患者置换后1年随访，置换后ROM、术后VAS评分差异无统计学意义(P＞0.05)，但与术前相比改善明显(P<0.05)；术后并发症发生率差异亦无统计学意义(P＞0.05)；术后1年KSS临床评分两组间差异无统计学意义，同期置换组KSS功能评分高于分期置换组(P<0.05)；两组术前、6个月、1年的WOMAC指数比较差异均无统计学意义(P＞0.05)。结论：同期双膝关节置换和分期双膝关节置换具有相同的临床效果和安全性，同时同期双膝关节置换具有减少住院时间、次数，并避免了二次手术的优势。
목적：비교동기쌍측여분기쌍측관절치환술치료슬골관절염적료효화안전성。방법：회고분석2010년4월—2013년6월전슬관절치환술환자43례，분위동기쌍측슬관절치환조(동기조, n=20)화분기쌍측슬관절치환조(분기조, n=23)，분별대량조환자치환전후적관절활동도(range of motion, ROM)、동통시각모의평분(visual analogue scale, VAS)、술후병발증、미국슬관절협회평분(American Knee Society Score,간칭KSS평분)계통급서안대략화맥극마사특대학골관절염지수(Western Ontario and McMaster Universities osteoarthritis index, WOMAC지수)진행비교분석。결과：량조환자치환후1년수방，치환후ROM、술후VAS평분차이무통계학의의(P＞0.05)，단여술전상비개선명현(P<0.05)；술후병발증발생솔차이역무통계학의의(P＞0.05)；술후1년KSS림상평분량조간차이무통계학의의，동기치환조KSS공능평분고우분기치환조(P<0.05)；량조술전、6개월、1년적WOMAC지수비교차이균무통계학의의(P＞0.05)。결론：동기쌍슬관절치환화분기쌍슬관절치환구유상동적림상효과화안전성，동시동기쌍슬관절치환구유감소주원시간、차수，병피면료이차수술적우세。
Objective:To compare the safety and clinical efficacy following simultaneous versus staggered bilateral total knee arthroplasty in treatment of osteoarthritis. Methods: Total 43 patients underwent total knee arthroplasty between April 2010 and June 2013, which included 20 simultaneous bilateral total knee arthroplasties and 23 staggered bilateral total knee arthroplasty. The preoperative and postoperative range of motion(ROM), visual analogue scale(VAS), postoperative complications, the Knee Society Score(KSS), Western Ontario and McMaster Universities osteoarthritis index(WOMAC) were compared. Results:Preoperatively there were no statistically significant significances between the 2 groups in the age, gender, body mass index(BMI), ROM, muscle strength, VAS and so on(P>0.05). There were no significances between two groups in postoperative complications, postoperative ROM, VAS at 1 year follow-up, except preoperative. No significantly differences were found with regard to postoperative KSS at 1 year follow-up. Knee Society function scores were higher in the simultaneous bilateral group. There were no statistically significances in the KSS and WOMAC between the simultaneous bilateral total knee arthroplasties group and the staggered bilateral total knee arthroplasty group at preoperation, 6 and 12 months postoperatively( P>0.05). Conclusion: It was concluded that simultaneous bilateral total knee arthroplasty is similar to that in the staggered bilateral total knee arthroplasty with carefully selecting patient and fully completing preoperative evaluation. And the bilateral total knee arthroplasty is superior to the hospitalization time, and avoiding the second surgery.