[1]孟庆阳,申晟,尚延春,等.肥胖对膝单髁置换术治疗膝关节内侧间室骨关节炎疗效和安全性影响的临床研究[J].中医正骨,2025,37(11):20-24，31.
　MENG Qingyang,SHEN Sheng,SHANG Yanchun,et al.Effects of obesity on efficacy and safety of unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(11):20-24，31.
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肥胖对膝单髁置换术治疗膝关节内侧间室骨关节炎疗效和安全性影响的临床研究()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年11期
页码:
20-24，31
栏目:
临床研究
出版日期:
2025-11-20

文章信息/Info

Title:
Effects of obesity on efficacy and safety of unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis:a clinical study
作者:
孟庆阳1; 申晟1; 尚延春1; 申明奎2
1.河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002; 2.河南省直第三人民医院,河南 郑州 450018
Author(s):
MENG Qingyang1; SHEN Sheng1; SHANG Yanchun1; SHEN Mingkui2
1.Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China 2.Henan No.3 Provincial People's Hospital,Zhengzhou 450018,Henan,China
关键词:
骨关节炎; 膝;  关节成形术; 置换; 膝;  肥胖症;  临床研究专题
Keywords:
osteoarthritis; knee;  arthroplasty; replacement; knee;  obesity;  clinical studies as topic
摘要:
目的:探讨肥胖对膝单髁置换术(unicompartmental knee arthroplasty,UKA)治疗膝关节内侧间室骨关节炎疗效和安全性的影响。方法:回顾性分析2020年1月至2022年1月采用UKA治疗的64例膝关节内侧间室骨关节炎患者的病例资料,其中体质量指数≥28 kg·m-2者(肥胖组)和体质量指数<28 kg·m-2者(非肥胖组)各32例。比较2组患者的手术时间、术后住院时间、术中出血量、术后引流量、膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、膝关节屈伸活动度及并发症发生率。结果:①围手术期指标。2组患者手术时间、术中出血量、术后引流量、术后住院时间的组间差异均无统计学意义(t=0.924,P=0.562; t=0.525,P=0.692; t=0.324,P=0.747; t=0.557,P=0.112)。②膝关节疼痛VAS评分。末次随访时,2组患者的膝关节疼痛VAS评分均较术前降低(t=34.765,P=0.000; t=29.764,P=0.000),且肥胖组的评分高于非肥胖组(t=9.351,P=0.035)。③HSS膝关节评分。末次随访时,2组患者的HSS膝关节评分均较术前提高(t=21.771,P=0.000; t=32.493,P=0.000),且肥胖组的评分低于非肥胖组(t=15.386,P=0.013)。④膝关节屈伸活动度。末次随访时,2组患者的膝关节屈伸活动度均较术前增大(t=21.933,P=0.000; t=26.482,P=0.000),且肥胖组的屈伸活动度小于非肥胖组(t=9.739,P=0.027)。⑤并发症发生率。肥胖组3例发生切口持续渗出、3例发生下肢深静脉血栓形成、2例发生假体无菌性松动,非肥胖组2例发生下肢深静脉血栓形成、1例发生假体无菌性松动。切口持续渗出者,经积极换药和抗感染治疗后切口渗出情况得到控制; 下肢深静脉血栓形成者,给予抗凝药物对症处理后症状缓解; 假体无菌性松动者,行全膝置换术后症状缓解。2组并发症发生率的差异无统计学意义(χ2=2.744,P=0.098)。结论:肥胖会影响UKA治疗膝关节内侧间室骨关节炎的疗效,但对其安全性无明显影响。
Abstract:
Objective:To investigate the effects of obesity on efficacy and safety of unicompartmental knee arthroplasty(UKA)in treatment of medial compartment knee osteoarthritis(KOA).Methods:The clinical data of 64 patients who underwent UKA for medial compartment KOA from January 2020 to January 2022 were retrospectively analyzed.The patients were divided into an obesity group(body mass index(BMI)≥28 kg/m(2))and a non-obesity group(BMI < 28 kg/m(2)),with 32 ones in each group.The operative time,postoperative hospital stay,intraoperative blood loss,postoperative drainage volume,knee pain visual analogue scale(VAS)score,Hospital for Special Surgery(HSS)knee score,knee range of motion(ROM),and complication incidence rate were compared between the 2 groups.Results:①Perioperative outcomes.There was no statistical difference in operative time,intraoperative blood loss,postoperative drainage volume,and postoperative hospital stay between the 2 groups(t=0.924,P=0.562; t=0.525,P=0.692; t=0.324,P=0.747; t=0.557,P=0.112).②Knee pain VAS score.At the last follow-up,the knee pain VAS scores decreased in both groups compared to the preoperative values(t=34.765,P=0.000; t=29.764,P=0.000),with higher values observed in the obesity group compared to non-obesity group(t=9.351,P=0.035).③HSS knee score.At the last follow-up,the HSS scores increased in both groups compared to the preoperative values(t=21.771,=0.000; t=32.493,P=0.000),with lower values observed in the obesity group compared to non-obesity group(t=15.386,P=0.013).④Knee flexion-extension ROM.At the last follow-up,the knee flexion-extension ROM increased in both groups compared to the preoperative values(t=21.933,P=0.000; t=26.482,P=0.000),with smaller values observed in the obesity group compared to non-obesity group(t=9.739,P=0.027).⑤Complication incidence rate.The complications included persistent incisional exudation(3 cases),lower limb deep venous thrombosis(3 cases),and aseptic prosthetic loosening(2 cases)were found in obesity group,while,only lower limb deep venous thrombosis(2 cases)and aseptic prosthetic loosening(1 cases)were found in non-obesity group.The persistent incisional exudation were successfully controlled by regular dressing changes and anti-infection treatment,the lower limb deep venous thrombosis were relieved by receiving symptomatic treatment with anticoagulants,and the aseptic prosthetic loosening was resolved by conversion to total knee arthroplasty.There was no statistical difference in the postsurgical complication incidence rate between the 2 groups(χ2=2.744,P=0.098).Conclusion:Obesity negatively affects the outcomes of UKA in treatment of medial compartment KOA,but it has no impact on its safety profile.

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2024ZY1019)
通讯作者:申晟 E-mail:shensheng416@163.com
更新日期/Last Update: 1900-01-01