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Title: [Comparison of the effectiveness of unicompartmental arthroplasty and total knee arthroplasty based on patient scale data].
Author: Zu X, Wang J, Lu M, Yin Z.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Dec 15; 35(12):1574-1579. PubMed ID: 34913314.
Abstract:
OBJECTIVE: To compare the patient-reported outcomes regarding function, joint amnesia, and the quality of life after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). METHODS: The clinical data of patients who received UKA or TKA between September 2017 and June 2018 were retrospectively analyzed. After propensity score matching, 40 patients (40 knees) each in TKA group and UKA group were finally included in the study. There was no significant difference between the two groups in gender, age, body mass index, surgical side, preoperative knee range of motion, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, clinical and function scores of knee society score (KSS) ( P>0.05). At 2 years after operation, WOMAC score, KSS clinical and function scores were performed on the two groups of patients, and compared with preoperative ones; knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), short-form 36 health survey scale (SF-36 scale), and forgotten joint score (FJS) were also performed. RESULTS: At 2 years after operation, the total score of WOMAC, the clinical and function scores of KSS in the two groups significantly improved when compared with preoperative ones ( P<0.05), but there was no significant difference in the total score of WOMAC, the individual score of WOMAC, the clinical and function scores of KSS between the two groups ( P>0.05). The total KOOS-PS score in the UKA group was significantly lower than that in the TKA group ( t=4.243, P=0.000), and the scores of writhing/knee rotation, kneeling, and squatting in the UKA group were significantly lower than those in the TKA group ( P<0.05). The total FJS score in the UKA group was significantly higher than that in the TKA group ( t=-6.334, P=0.000). In the UKA group, the scores of 7 items were significantly lower than those of the TKA group ( P<0.05) including when walking over 15 minutes, when climbing stairs, when walking on uneven ground, when standing for long periods, when doing housework or gardening, when taking a walk or hiking, and when doing your favorite sport. The SF-36 scales of physiological function, energy, social function, emotional function, and mental health in the UKA group were significantly higher than those in the TKA group ( P<0.05). CONCLUSION: Compared with TKA, patients treated with UKA may have better knee function recovery, joint amnesia, and higher quality of life. 目的: 比较单髁置换术（unicompartmental knee arthroplasty，UKA）和人工全膝关节置换术（total knee arthroplasty，TKA）患者术后膝关节功能、关节遗忘度和生活质量。. 方法: 回顾分析2017年9月—2018年6月接受UKA或TKA治疗且符合选择标准的患者临床资料，经倾向评分匹配后最终纳入研究的TKA组和UKA组患者均为40例（40膝）。两组患者性别、年龄、身体质量指数、手术侧别及术前膝关节活动度、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、膝关节学会评分（KSS）临床和功能评分比较差异均无统计学意义（ P>0.05）。术后2年对两组患者行WOMAC评分、KSS临床和功能评分，并与术前比较；同时行膝关节损伤和骨关节炎结局评分-身体功能（KOOS-PS）、简明健康调查量表（SF-36量表）及关节遗忘评分（FJS）。. 结果: 术后2年，两组患者WOMAC总分及KSS临床和功能评分均较术前显著改善（ P<0.05）；两组间WOMAC总分和各项评分及KSS临床和功能评分手术前后差值比较，差异均无统计学意义（ P>0.05）。UKA组KOOS-PS总分明显低于TKA组（ t=4.243， P=0.000），其中UKA组在扭动/以膝盖为中心转动、跪下、蹲着3项评分上显著低于TKA组（ P<0.05）。UKA组FJS总分明显高于TKA组（ t=−6.334， P=0.000），其中UKA组在当步行超过15 min、当爬楼梯时、当不在平坦的地面行走时、当长期站立时、当做家务或园艺时、当散步或远足时、当做最喜欢的运动时7项评分上显著低于TKA组（ P<0.05）。UKA组SF-36量表评分中的生理机能、精力、社会职能、情感职能和精神健康5项评分显著高于TKA组（ P<0.05）。. 结论: 与TKA相比，UKA患者的膝关节功能可能恢复更好，关节遗忘度和生活质量可能更高。.

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