Analysis Of The Early Effect Of Unicompartmental Knee Arthroplasty In The Treatment Of Advanced Simple Medial Compartment Osteoarthritis

Background: With the aging of the population and changes in lifestyle,the incidence of knee osteoarthritis is getting higher and higher,and about one-third of the lesions are limited to the medial tibiofemoral compartment.Currently,Total Knee Arthroplasty(TKA)and Unicompartmental Knee Arthroplasty(UKA)are the main options for the treatment of advanced single-compartment knee osteoarthritis.Total knee arthroplasty is widely used because of its satisfactory clinical efficacy and good long-term survival rate,while unicompartmental knee replacement in the early stage is not valued because of its high failure rate and revision rate.In recent years,due to continuous improvement of surgical indications,gradual improvement of prosthesis design,more and more new materials,continuous improvement of surgical technology,especially the rapid progress of minimally invasive technology,and the success rate of single replacement surgery The survival rate has gradually improved.However,there is still controversy about the surgical indications and clinical efficacy of unicompartmental knee replacement surgery,and there is no unified and clear statement.In addition,few studies have reported the clinical efficacy of unicompartmental knee replacement for the treatment of advanced medial knee osteoarthritis.Therefore,it is necessary to further clarify the surgical indications for patients with advanced simple medial knee osteoarthritis to undergo unicompartmental knee replacement and Corresponding clinical efficacy to guide the clinic.Objective: To compare the early effects of unicompartmental knee replacement and total knee arthroplasty in the treatment of advanced knee medial compartment osteoarthritis,and to explore the factors that affect the effectiveness of unicompartmental knee replacement and the surgical techniques.Methods: From April 2017 to February 2019,patients who underwent knee arthroplasty in our hospital’s joint surgery for advanced simple medial compartment knee osteoarthritis were selected.A total of 62 patients who met the criteria were selected and 30 of them met the criteria of unicompartmental knee arthroplasty,32 patients underwent total knee arthroplasty.The SPSS 22.0 statistical software was used to compare knee function scores and knee joints of the United States Special Surgery Hospital(HSS)before,6 months,and 12 months after the operation of the single knee replacement group and the total knee replacement group.Range of motion(ROM)and femoral-tibial angle(FTA).Comparison of surgical time,hospital stay,intraoperative blood loss,perioperative blood transfusion rate,and complications within one year Rate and revision rate,and compare the HSS scores before and after surgery,knee range of motion(ROM),femur-tibia angle(FTA)in the single condyle group,and the HSS scores and knee activity in the whole knee group before and after surgery.Degree ROM,femoral-tibia angle(FTA),to evaluate the early clinical effects of unicondylar knee replacement and total knee replacement for advanced simple knee medial compartment osteoarthritis.Results:Through statistical analysis and comparison,the preoperative general data including HSS score,ROM,and FTA of the two groups of patients were not significantly different(P>0.05).The HSS score and ROM of the two groups were significantly higher than those before surgery in the 1 year after surgery.The femoral-tibial angle in the next 1 year was smaller than that in the preoperative period,and the difference was statistically significant(P<0.05).The HSS score in the single condyle group was higher than that of the total knee group at 6 months after surgery,and the difference was statistically significant(P<0.05).The HSS score was slightly higher than that of the total knee group,but the difference was not statistically significant(P>0.05).The ROM and FTA of the single condyle group were higher than that of the total knee group at 6 months and 1 year after surgery,and the differences were statistically significant(P<0.05).The time,length of hospital stay,and intraoperative blood loss were lower than those of the total knee group,and the differences were statistically significant(P<0.05).The perioperative blood transfusion rate in the single condyle group was slightly lower than that of the total knee group,but the differences were not statistically significant(P>0.05).The postoperative follow-up period was 1 year.;During the 1-year follow-up period,there were no cases of death, intra-articular and incision infections,deep venous thrombosis of the lower limbs;During the 1-year follow-up period,there were no cases requiring revision due to poor prosthesis position,prosthesis loosening,prosthesis wear and tear,prosthesis sinking,or progressive osteoarthritis in the remaining compartment.Conclusion:Both unicondylar knee replacement and total knee replacement can effectively treat advanced simple medial compartment knee osteoarthritis,both of which have very satisfactory early clinical efficacy and good safety.Compared with total knee arthroplasty,unicondylar knee replacement has less trauma,less osteotomy,less intraoperative blood loss,less damage to the surrounding soft tissue,shorter bed-rest time and faster postoperative recovery,but the surgical indications of single condyle replacement surgery are stricter and more limited than total knee replacement surgery,the surgical operation is relatively complicated,and the ability to correct lower limb deformities is relatively limited.Therefore,only by strictly grasping the indications for surgery and the key points of surgery can we maximize the advantages of surgery.