膝关节单髁置换术后快速康复的临床疗效分析

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Abstract Objective To investigate the effect of enhanced recovery after surgery (ERAS) pathway on the early outcomes，satisfaction and complications of unicompartmental knee arthroplasty (UKA).Methods A randomized controlled trial was conducted on 50 cases of unicompartmental knee arthroplasty (UKA) in our department from January 2016 to January 2018.50 patients were randomly dividedinto ERAS group (n＝25) or non-ERAS group (n＝25).There were 25 cases in ERAS group，including 11 males and 14 females，with an average age of (60.2±4.9) years (49~69 years)； There were 25 cases in non-ERAS group，including 10 males and 15 females，with an average age of (59.8±5.1) years (47~69 years).The blood loss，length of stay(LOS)，mean decrease of hemoglobin 3 days after operation and total hospitalization expenses were compared.The effectiveness was evaluated by HSS score，VAS score，range of motion(ROM) and subjective satisfaction score at 1，3 and 12 months after operation.At the lastest follow-up，postoperative complications such as periprosthetic joint infection(PJI)，prosthetic loosening and deep venous thrombosis(DVT) were recorded.Results The blood loss during operation，mean decrease of hemoglobin 3 days after operation，the length of stay and total hospitalization expenses in ERAS group were lower than those in non-ERAS group (P＜0.05).Both groups were followed up 12~22 months(mean，16.9 months).HSS score in ERAS group was higher than that in non-ERAS group at 1 month and 3 months after operation (P＜0.05)，and there was no significant difference in HSS score between two groups at 12 months after operation (P＞0.05).The ROM of ERAS group was higher than that of non-ERAS group at 1 month，3 months and 12 months after operation (P＜0.05).The VAS score of ERAS group was lower than that of non-ERAS group before operation and at POD 1~4 (P＜0.05).At the last follow-up，no complication such as periprosthetic joint infection，prosthetic loosening，deep venous thrombosis(DVT) occurred in all cases.Conclusion Enhanced recovery after surgery(ERAS) can reduce early postoperative pain，promote early recovery，improve the early effect of unicompartmental knee arthroplasty(UKA) and gain a better postoperative satisfaction.

Key words： unicompartmental knee arthroplasty knee osteoarthritis enhanced recovery after surgery early effectiveness randomized controlled trial

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