| Research background and purpose:Unicompartmental Knee Arthroplasty(UKA)has the advantages of less trauma,less bleeding,and faster postoperative functional recovery.In the development of unicompartmental knee arthroplasty,surgical approach changes constantly.The current surgical approaches for unicondylar replacement mainly include traditional approaches and minimally invasive approaches.In recent years,there have been a large number of clinical studies showing that the minimally invasive approach for unicondyle replacement can achieve good clinical results and higher patient satisfaction.However,there is currently a lack of comparative study of minimally invasive approaches and traditional approaches in China.This study focuses on comparing the clinical efficacy of minimally invasive and traditional knee joint arthroplasty and evaluating the advantages and disadvantages of the two surgical approaches.Materials and methods:A retrospective controlled study was used to select 76knees of 74 patients who underwent unicondyle replacement in our hospital from February 2017 to June 2019.The operations were performed by the same group of doctors,all using cemented third-generation Oxford prosthesis.The follow-up time was 1.2 to 3 years,with an average of 2.3 years.According to their different surgical incisions,they are divided into minimally invasive approach group and traditional approach group.Among them,there were 40 knees with UKA in the minimally invasive approach group,8 males and 32 females,with an average age of(60.23±6.45)years and body mass index(26.0±2.33)kg/m~2;36 knees in the traditional approach group,8 males and 28 females.,with an average age of(62.3±5.59)years old,and the body mass index was(26.1±2.76)kg/m~2.Case review,outpatient follow-up and video follow-up were used to record and count the operation time,incision length,surgical blood loss,quadriceps muscle strength,VAS score,HSS score,tibiofemoral angle,posterior slope angle,lateral distal femoral angle,medial proximal tibial angle and skin numbness were analyzed statistically using SPSS20.0 software to compare the differences between the two groups.Results:There was no significant difference in preoperative baseline data and clinical data(HSS score Kellgren-Lawrence classification,etc.)between the two groups.The incision length of the minimally invasive approach group was7.9±0.65cm,which was significantly shorter than that of the traditional approach group.The incision length was 12.4±0.84cm(P<0.05);the operation time of the minimally invasive approach group(75.1±15.44min)was similar to that of the traditional approach group(75.6±10.84min)and there was no statistical difference;The postoperative CRP value of the traditional approach group was 29.1±18.7mg/L,and the postoperative creatine kinase was 154.8±61.7 u/L,The postoperative CRP value of the minimally invasive approach group was12.1±11.88mg/L,and the postoperative creatine kinase was 79.4±18.90u/L.Here is a significant difference between the two groups.The Hb variation in the minimally invasive approach group was 5.7±7.90 g/L,and the Hb variation in the traditional approach group was 7.9±5.77 g/L.There was no significant difference between the two groups(P=0.17);The VAS scores of the minimally invasive approach group were lower than those of the traditional approach group at 3 days、2 weeks and 1 month after operation,and the difference was statistically significant(P<0.05).The muscle strength of the minimally invasive approach group was higher than that of the traditional approach group at 2 weeks postoperatively,and the difference was significant(P<0.05).One month after operation,the HSS score of the knee joint in the minimally invasive approach group was higher than that of the traditional approach group,and the difference was statistically significant(P<0.05);There were no significant differences in the imaging scores of tibiofemoral angle,posterior slope angle,lateral distal femoral angle,medial proximal tibial angle,and the numbness of the knee joint skin.Conclusion:The minimally invasive approach of UKA and the traditional approach of UKA can achieve similar clinical effects,but the minimally invasive approach of UKA has a smaller incision,less trauma,quicker recovery of postoperative muscle strength,less postoperative pain,and more rapid recovery of knee function than the traditional approach UKA. |
