加速康复外科理念指导下混合型单髁关节置换术后的疗效分析

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Abstract Objective To explore the clinical outcomes of the primary mixed unicompartmental knee arthroplasty(UKA) under the guidance of enhanced recovery after surgery(ERAS) in the treatment of anteromedial knee osteoarthritis.Methods From February 2018 to June 2019，a total of 75 patients who underwentprimary mixed unicompartmental knee arthroplasty for anteromedial osteoarthritis in our hospital were enrolled in this study underwent and randomly divided into two groups，which included 40 cases of surgical patients guided by the concept of enhanced rehabilitation(observation group) and 35 cases of routine surgery patients(control group).There were 17 males and 23 females in the observation group，aged 47~82 years old，with an average of (58.63±7.95)years；in the control group，10 males and 25 females，aged 46~71 years old，with an average of (60.80±5.76)years old.The surgical blood loss，postoperative time in the field，hospitalization time，24 h postoperative hemoglobin reduction，postoperative pain score Visual Analogue Scale/Score(VAS)，Hospital for Special Surgery(HSS) knee score，knee Joint Range of Motion(ROM) after surgery were compared.The postoperative complications such as infection，prosthesis loosening，fractures around the prosthesis，and deep vein thrombosis of the lower extremities were recorded at the last follow-up.Results Intraoperative blood loss，postoperative time in the field，and hospital stay in observation group was significantly lower than that of the control group(P＜0.05).The value of hemoglobin reduction at 24 hours after surgery in observation group was significantly lower than that of the control group(P＜0.05).VAS pain score at 1 day，3 days，7 days，1 month and 3 months after surgery，HSS score at 1 month and 3 months after surgery，and the ROM in observation group were better than the control group(P＜0.05).The VAS score，knee HSS score，and postoperative ROM at 12 months after operation had no significance difference (P＞0.05).Conclusion The primary mixed unicompartmental knee arthroplasty guided by the concept of ERAS can effectively control pain，reduce intraoperative bleeding，improve knee joint function，shorten hospital stay，reduce complications，and promote early recovery of patients，improve satisfaction and promote rapid recovery of patients.

Key words： unicompartmental knee arthroplasty anteromedial knee osteoarthritis accelerated rehabilitation mixed unicompartmental knee arthroplasty

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