Observation of the Curative Effect of Unicondyle Replacement Under the Application of Accelerated Rehabilitation Surgery (ERAS) in the Treatment of Anteromedial Knee Osteoarthritis
Department of Orthopaedics，Peking University Shougang Hospital
摘要目的 评估在加速康复外科理念(enhanced recovery after surgery，ERAS)下采用单髁置换术治疗膝关节前内侧间室骨关节炎(anterior medial osteoarthritis of the knee，AMOA)的疗效。方法 选取2019年2月至2020年7月于我院住院，在ERAS模式下进行单髁置换手术治疗的患者41例，其中男11例，女30例；年龄51~82岁，平均(68.20±7.23)岁。记录手术时间、术中出血量、术后并发症，比较手术前后疼痛视觉模拟评分(visual analogue scale，VAS)，比较术前及末次随访时美国特种外科医院膝关节(hospital for special surgery，HSS)评分及术后6周、3个月、6个月的膝关节遗忘评分(forgotten joint score，FJS-12)。结果 患者均获得随访，随访时间6~22个月，平均(15.07±4.38)个月，所有患者的影像学检查显示假体位置良好，无松动，无感染，无衬垫脱位。术后VAS评分(1.63±0.49)分，与术前(5.81±0.87)分相比较，差异有统计学意义(P＜0.001)。末次随访时膝关节HSS评分(95.29±2.38)分，与术前(62.07±3.80)分相比较，差异有统计学意义(P＜0.001)。术后6周FJS12评分为(15.83±5.11)分，术后3个月为(8.07±3.05)分，二者比较差异有统计学意义(P＜0.001)，术后6个月为(6.39±2.88)分，与术后3个月相比较差异有统计学意义(P＜0.001)，但无实际临床意义。结论 在加速康复外科理念下采用单髁置换术可以有效治疗膝关节前内侧骨关节炎，并在术后较早时间内达到较高的关节遗忘度。
Abstract：Objective To evaluate the efficacy of unicompartmental knee arthroplasty with the application of enhanced recovery after surgery (ERAS)principle in the treatment of anteromedial osteoarthritis of the knee.Methods 41 cases who underwent unicompartmental knee arthroplasty under the accelerated rehabilitation surgery(ERAS) routine in our department from February 2019 to July 2020 were involved in the research.We document the operation time，intraoperative blood loss，post-operative complications，the visual analogue scale(VAS) scores before and after the operation，the Hospital for Special Surgery(HSS) Knee Scoring before the operation and during the last follow-up，and the forgotten joint score (FJS-12) at 6 weeks，3 months and 6 months after the surgery. Results 41 knees of 41 cases underwent medial unicompartmental knee arthroplasty.The patients were followed up for 6~22 months (15.07±4.38)months).The radiology examination of all cases indicated that the prostheses were in good position，without loosening，infection or dislocation of the liner.During the last follow-up，the preoperative VAS score (5.81±0.87) and the postoperative VAS score(1.63±0.49) were significantly different，with t＝24.956，P＜0.001.The preoperative HSS score (62.07±3.80) of the knee joint was significantly different with the valueat the last follow-up (95.29±2.38) with t＝45.427，P＜0.001.The FJS-12 score after 6 weeks (15.83±5.11) and 3 months (8.07±3.05) were statistically different (t＝11.842，P＜0.001)，so as for the FJS-12 score after 3 months (8.07±3.05) and 6 months (6.39±2.88)，with a statistical significance (t＝7.674，P＜0.001)，yet there was no clinical significance.Conclusion With the application of the accelerated rehabilitation surgery，the outcome of the unicompartmental knee arthroplasty is satisfactoryin thetreatment ofanteromedial knee osteoarthritis，andthe effect of forgotten knee is expected within a short postoperative period.
张辉，裴征，薛喆，李沼，贾俊秀，张克石，关振鹏 *. 在加速康复外科理念下采用单髁置换术治疗膝关节前内侧骨关节炎的疗效观察[J]. 实用骨科杂志, 2021, 27(8): 694-698.
Zhang Hui，Pei Zheng，Xue Zhe，et al. Observation of the Curative Effect of Unicondyle Replacement Under the Application of Accelerated Rehabilitation Surgery (ERAS) in the Treatment of Anteromedial Knee Osteoarthritis. sygkzz, 2021, 27(8): 694-698.
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