| 单髁置换术治疗高龄膝关节骨关节炎疗效的倾向评分匹配研究 |
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Received:May 18, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 凌晶 |
LING Jing |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
lingjing07@163.com |
| 涂以济 |
TU Yi-ji |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 王识程 |
WANG Shi-cheng |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 章军辉 |
ZHANG Jun-hui |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 狄正林 |
DI Zheng-lin |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Department of Joint Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 期刊信息：《中国骨伤》2023年36卷，第2期，第151-156页 |
| DOI：10.12200/j.issn.1003-0034.2023.02.011 |
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目的：探讨单髁置换术(unicompartmental knee arthroplasty,UKA)治疗75岁以上高龄膝关节骨关节炎(膝骨关节炎)患者的疗效。
方法：回顾分析自2014年10月至2020年11月接受初次固定平台单髁置换手术患者疗效。通过倾向性评分匹配(propensity score matching,PSM)对年龄、身体质量指数(body mass index,BMI)、关节活动度(range of motion,ROM)、术前关节功能评分、生活质量评分等术前指标进行匹配分为高龄组(≥ 75岁)和对照组(<75岁),记录两组手术前后膝关节活动度,牛津膝关节功能评分(Oxford knee score,OKS),Western Ontario McMaster大学骨性关节炎指数(Western Ontario McMaster Universities osteorthritis index,WOMAC),生活质量简表生理评分(short form-12 physical component summary,SF-12 PCS),生活质量简表心理评分(short form-12 mental component summary,SF-12 MCS),达到评分系统最小临床差异值(minimal clinically important difference,MCID)例数以及临床并发症进行组间对比。
结果：共分析514例患者,428例患者符合准入条件作为研究对象。根据术前变量进行1:2倾向性匹配后,分为高龄组84例(≥ 75岁),年龄75~88(78.79±3.08)岁,随访时间12~84(29.35±16.52)个月;对照组168例(<75岁),年龄47~74(64.10±5.96)岁,随访时间12~85(31.83±17.34)个月。高龄组与对照组术前基线资料对比仅年龄差异有统计学意义(P<0.01)。高龄组术后关节功能WOMAC评分高于对照组,SF-12 PCS评分低于对照组,膝关节活动度、OKS、各评分系统达到最小临床差异值的比例高龄组与对照组间比较差异无统计学意义(P>0.05)。高龄组较对照组围术期有更多的切口并发症与谵妄发生率(P<0.05),在心血管事件、脑血管事件、尿潴留、下肢静脉血栓、影像学假体周围透亮线发生率上高龄组与对照组间比较差异无统计学意义(P>0.05)。
结论：单髁置换术治疗75岁以上高龄膝骨关节炎患者,可以取得满意的近期临床疗效,安全性良好。 |
| [关键词]:膝关节 关节成形术,置换,膝 骨关节炎,膝 倾向得分匹配研究 |
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| Propensity score-matched study of uni-condylar arthroplasty in elderly patients with knee osteoarthritis |
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Abstract:
Objective To investigate the clinical efficacy of unicompartmental knee arthroplasty (UKA) in the treatment of knee osteoarthritis in patients over 75 years old.
Methods The clinical efficacy of primary fixed platform UKA in patients with osteoarthritis,was retrospectively analyzed from October 2014 to November 2020.Age,body mass index (BMI),range of motion (ROM),preoperative joint function score,the quality of life score and other preoperative indicators were measured by propensity score matching (PSM).The patients were divided into elderly group (≥ 75 years old) and control group (<75 years old).Oxford knee score (OKS),Western Ontario McMaster Universities osteoarthritis index (WOMAC),Short Form-12 including physical component summary (PCS),mental component summary (MCS),minimal clinically important difference (MCID) and clinical complications were evaluated preoperatively and postoperatively.
Results A total of 514 patients were analyzed,428 patients fulfilled the inclusion criteria.A propensity-score matching study was conducted to eliminate confounding factors.After 1:2 propensity match,there were 84 patients in elderly group (≥ 75 years),age ranged from 75 to 88 years old,with an average of (78.79±3.08) years old,and 168 patients in control group (<75 years),age ranged from 47 to 74 years old,with an average of (64.10±5.96) years old.The follow-up duration of two groups ranged from 12 to 84 months with an average of (29.35±16.52) months in elderly group,and 12 to 85 months with an average of (31.83±17.34) months in control group.There was only significant difference in age between the elderly and control groups preoperatively (P<0.01).Postoperatively,the elderly group showed significantly higher WOMAC (P<0.01) and lower SF-12 PCS scores (P<0.01) as compared to the control group.There was no significant difference between the elderly group and the control group in knee range of motion,OKS and the proportion of each scoring system reaching the minimum clinical difference value (P>0.05).In the aspect of preperative complications,the elderly group exhibited more surgical site complications and postoperative delirium compared to control group (P<0.05).The differences in other indicators including deep vein thrombosis,acute urinary retention,cardiovascular events,cerebrovascular events and radiolucent lines around prothesis were not statistically significant (P>0.05).
Conclusion UKA in the treatment of elderly patients over 75 years old with knee osteoarthritis was safe and feasible,and could obtain satisfactory short-term efficacy. |
| KEYWORDS:Knee joint Arthroplasty,Replacement,knee Osteoarthritis,knee Propensity score matching study |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 凌晶,涂以济,王识程,章军辉,狄正林.单髁置换术治疗高龄膝关节骨关节炎疗效的倾向评分匹配研究[J].中国骨伤,2023,36(2):151~156 |
| 英文格式: | LING Jing,TU Yi-ji,WANG Shi-cheng,ZHANG Jun-hui,DI Zheng-lin.Propensity score-matched study of uni-condylar arthroplasty in elderly patients with knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(2):151~156 |
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